摘要译文（供参考）

老年患者手术日当晚睡眠质量与术后谵妄的关系： 

一项前瞻性队列研究

背景： 围手术期睡眠障碍与不良结局相关，包括术后谵妄 （POD）。然而，对术后即刻睡眠质量的研究是有限的。

目标： 本研究旨在调查使用睡眠质量数字评定量表 （SQ-NRS） 评估手术日当晚睡眠质量与大型手术患者队列中 POD 发生率之间的关联。

设计： 一项前瞻性队列研究。

实施： 中国的一家三级医院。

病人： 本研究招募了 65 岁或以上在全身麻醉下接受择期手术的患者。参与者根据他们的手术夜间 SQ-NRS 分为睡眠障碍组和无睡眠障碍组。

主要结局指标： 主要结局是谵妄发生率，而次要结局包括术后 1 年内的急性肾损伤、卒中、肺部感染、心血管并发症和全因死亡率。

结果： 本研究的分析共包括 3072 名患者。其中，791 例 （25.72%） 在手术当天晚上出现睡眠障碍。睡眠障碍组患者发生 POD 的风险显著升高 （校正 OR 1.43,95% CI 1.11 至 1.82，P = 0.005）。亚组分析显示，年龄 65-75 岁;男性;ASA III 和 IV;血红蛋白超过 12 g l -1 ;术中低血压;手术时间超过 120 分钟;和 9 年或更短的教育与 POD 显著相关。亚组之间未观察到交互作用。术后 1 年内急性肾损伤、卒中、肺部感染、心血管并发症和全因死亡率等次要结局无显著差异。

结论： 手术当天晚上主观睡眠质量差与 POD 风险增加独立相关，尤其是在某些亚群中。优化围手术期睡眠可能会减少 POD。进一步的研究应调查潜在的机制和因果关系。

试验注册： chictr.org.cn：ChiCTR1900028545。

原文摘要

Association of sleep quality on the night of operative day with postoperative delirium in elderly patients: A prospective cohort study

Background: Sleep disturbances in the peri-operative period have been associated with adverse outcomes, including postoperative delirium (POD). However, research on sleep quality during the immediate postoperative period is limited.

Objectives: This study aimed to investigate the association between sleep quality on the night of the operative day assessed using the Sleep Quality Numeric Rating Scale (SQ-NRS), and the incidence of POD in a large cohort of surgical patients.

Design: A prospective cohort study.

Setting: A tertiary hospital in China.

Patients: This study enrolled patients aged 65 years or older undergoing elective surgery under general anaesthesia. The participants were categorised into the sleep disturbance and no sleep disturbance groups according to their operative night SQ-NRS.

Main outcome measures: The primary outcome was delirium incidence, whereas the secondary outcomes included acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively.

Results: In total, 3072 patients were included in the analysis of this study. Among them, 791 (25.72%) experienced sleep disturbances on the night of operative day. Patients in the sleep disturbance group had a significantly higher risk of developing POD (adjusted OR 1.43, 95% CI 1.11 to 1.82, P = 0.005). Subgroup analysis revealed that age 65-75 years; male sex; ASA III and IV; haemoglobin more than 12 g l -1 ; intra-operative hypotension; surgical duration more than 120 min; and education 9 years or less were significantly associated with POD. No interaction was observed between the subgroups. No significant differences were observed in the secondary outcomes, such as acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively.

Conclusions: The poor subjective sleep quality on the night of operative day was independently associated with increased POD risk, especially in certain subpopulations. Optimising peri-operative sleep may reduce POD. Further research should investigate potential mechanisms and causal relationships.

Trial registry: chictr.org.cn: ChiCTR1900028545.