老年非心臟手術(shù)患者基礎(chǔ)腦氧合與術(shù)后結(jié)局的相關(guān)性
貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組
翻譯：王貴龍 編輯：趙游霄 審校：曹瑩
目前需要常用的風(fēng)險評估策略來加強(qiáng)圍手術(shù)期管理，特別是對于術(shù)后不良結(jié)局風(fēng)險增加的衰弱患者。此前有研究報道較低的基礎(chǔ)腦氧飽和度（rSO2）與心臟手術(shù)患者的死亡率增加有關(guān)。研究者假設(shè)較低的基礎(chǔ)rSO2可能是老年非心臟手術(shù)患者術(shù)后不良結(jié)局易感性增加的評估替代指標(biāo)。
研究者對一項(xiàng)前瞻性觀察性隊(duì)列研究進(jìn)行了探索性二次分析，納入2017年至2019年間計(jì)劃行擇期非心臟手術(shù)的65歲以上患者。入院時測量基礎(chǔ)rSO2。主要觀察指標(biāo)是手術(shù)后30天內(nèi)的發(fā)病率和死亡率。
在254名患者中：65%為男性，17名（7%）在手術(shù)后30天內(nèi)再次入院，5名在此期間死亡（2%）。基礎(chǔ)rSO2值與再入院率及死亡率具有相關(guān)性?；A(chǔ)rSO2的死亡率預(yù)測顯示AUC為0.801（p=0.021）。
rSO2作為術(shù)后不良結(jié)局的生物標(biāo)志物，可用于非心臟手術(shù)患者，尤其是老年人群。
原始文獻(xiàn)：
Mariana Thedim ；Maria J Susano ；Francisco S Seixas ；Sérgio Vide ；Susana Vacas ；Association between baseline cerebral oxygenation and postoperative outcomes in older noncardiac surgical patients: An exploratory observational study；J Clin Anesth；2025 Mar 4:103:111806.doi: 10.1016/j.jclinane.2025.111806.
英文原文：
Association between baseline cerebral oxygenation and postoperative outcomes in older noncardiac surgical patients: An exploratory observational study
BACKGROUND: Universal risk assessment strategies are needed to enhance perioperative care, especially for vulnerable patients at increased risk for adverse postoperative outcomes. Lower baseline regional cerebral oxygen saturation (rSO(2)) was previously associated with increased mortality in cardiac surgical patients. We hypothesised that lower baseline rSO(2) could be a surrogate of increased vulnerability to adverse postoperative outcomes in older noncardiac surgical patients.
METHODS: We conducted an exploratory secondary analysis of a prospective observational cohort study. Patients over 65 years scheduled for elective noncardiac surgery between 2017 and 2019 were included. Unilateral baseline rSO(2) was measured upon admission to the surgical ward. Our primary outcomes were morbidity and mortality rates within 30 days of the surgical procedure.
RESULTS: Among 254 analysed patients (median [25th percentile, 75th percentile] age 73 [68, 78], 65 % males), 17 (7 %) were readmitted to the hospital within 30 days after surgery, and five died in this period (2 %). Baseline rSO(2) values were significantly associated with readmission (mean (SD), 58 (10) vs 65 (8), P = 0.003) and mortality (mean (SD), 51 (15) vs 64 (8), P < 0.001). Mortality prediction based on baseline rSO(2) revealed an AUC of 0.801 (p = 0.021).
CONCLUSIONS: The utility of baseline rSO(2) as a biomarker of adverse postoperative outcomes can potentially extend to noncardiac surgical patients, especially for older populations.
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