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Abstract:
PURPOSE:Our objective was to examine the association between preoperative cognitive status and postoperative recovery from anesthesia. METHODS:We included patients (70-91 years old) from the Mayo Clinic Study of Aging who received general anesthesia and were admitted to the postanesthesia care unit from January 1, 2010 through April 30, 2018. Procedures were categorized according to patient's preoperative cognitive status: cognitive impaired (CI) and cognitive unimpaired (CU). Perioperative records were reviewed and analyses were performed with generalized estimating equations. RESULTS:A total of 896 procedures from 611 patients were included, with 203 (22.7%) procedures in the CI group. Compared to CU procedures, CI procedures had higher rates of moderate-deep sedation during anesthesia recovery (52 [25.6%] vs. 103 [14.9%]; odds ratio [OR], 1.91; 95% CI, 1.30-2.80; P < 0.01), postoperative pulmonary complications (22 [10.8%] vs. 34 [4.9%]; OR, 2.36[1.22-4.54]; P = 0.01), and postoperative delirium (32 [16.2%] vs. 24 [3.5%]; OR, 5.33 [2.88-9.86]; P < 0.01). When moderate-deep sedation during anesthesia recovery was a covariate, both CI (OR, 3.02[1.60-5.70]; P < 0.01) and moderate-deep sedation (OR, 3.94[2.19-7.11]; P < 0.01) were associated with delirium. In multivariable analysis, postoperative pulmonary complications were associated with moderate-deep sedation (OR, 2.14[1.18-3.87]; P = 0 .01) but not with CI (OR, 1.49 [0.76-2.92]; P = 0 .25). CONCLUSIONS:Cognitive impairment was associated with higher rates of moderate-deep residual sedation during anesthesia recovery and delirium, while moderate-deep sedation was associated with higher rates of pulmonary complications and delirium. We speculate that tailoring the anesthetic to facilitate faster emergence for CI patients could improve complication rates.
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最新影响因子:2.931 | 期刊ISSN:0913-8668 | CiteScore:1.26 |
出版周期:Quarterly | 是否OA:YES | 出版年份:1987 |
期刊官方网址:http://www.springer.com/medicine/anesthesiology/journal/540
自引率:9.30% | 研究方向:医学-麻醉学 |
出版地区:JAPAN |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Published by Springer. ISSN (printed): 0913-8668. ISSN (electronic): 1438-8359. The Journal of Anesthesia is the official journal of the Japan Society of Anesthesiology.
由斯普林格出版。ISSN(印刷体):0913-8668。ISSN(电子版):1438-8359。 《麻醉学杂志》是日本麻醉学学会的官方刊物。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
ANESTHESIOLOGY (麻醉学) 4区 |
26/31 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
122 | 115 | 7 |
引文计数(2018)
文献(2015-2017)
732次引用
583篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Anesthesiology and Pain Medicine
|
#48/115
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研究方向:麻醉
审稿时间: 3个月内 接受率: 中等(50%命中)
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研究方向:麻醉
接受率: 比较困难(25%命中)
影响因子:2.438
ISSN:0261-1929
研究方向:农林科学-兽医学
影响因子:3.025
ISSN:1094-7159
研究方向:医学-临床神经学
影响因子:4.169
ISSN:0264-410X
研究方向:医学-免疫学
影响因子:17.579
ISSN:0022-1007
研究方向:医学-免疫学
影响因子:5.274
ISSN:0971-5916
研究方向:医学-免疫学
影响因子:4.061
ISSN:2314-6745
研究方向:ENDOCRINOLOGY & METABOLISM-MEDICINE, RESEARCH & EX
影响因子:2.976
ISSN:0914-8779
研究方向:医学-内分泌学与代谢
影响因子:4.75
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研究方向:医学-内分泌学与代谢
影响因子:10.171
ISSN:1931-5244
研究方向:医学-医学:内科
发表一篇学和医学成像类SCI论文
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