Pisani Margaret A, McNicoll Lynn, Inouye Sharon K
Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8057, USA.
Clin Chest Med. 2003 Dec;24(4):727-37. doi: 10.1016/s0272-5231(03)00092-3.
Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU. This pre-existing cognitive impairment is an important predisposing risk factor for the development of delirium during and after the ICU stay. Given the high rates of delirium in the ICU that range from 50% to 80% (see references [27, 28, 34]), future studies are urgently needed to examine risk factors for delirium in the ICU setting, such as examining the impact of psychoactive medication use on delirium rates and persistence in the ICU setting. Moreover, studies that examine the impact of delirium prevention in the ICU on rates of delirium, duration and persistence of delirium, and long-term cognitive and functional outcomes post-ICU stay are greatly needed.
谵妄是重症监护病房（ICU）老年患者常见的并发症，且常在其ICU住院期间过后仍持续存在。ICU老年患者的谵妄是一个动态且复杂的过程。入住内科ICU的患者中，既往存在认知障碍的比例很高。这种既往存在的认知障碍是ICU住院期间及出院后发生谵妄的一个重要易感风险因素。鉴于ICU中谵妄的发生率高达50%至80%（见参考文献[27, 28, 34]），迫切需要开展进一步研究，以探究ICU环境中谵妄的风险因素，例如研究精神活性药物的使用对ICU环境中谵妄发生率及持续时间的影响。此外，非常需要开展研究，以探究ICU中谵妄预防措施对谵妄发生率、谵妄持续时间及持续状态，以及ICU住院后长期认知和功能结局的影响。
