Wancata Johannes, Windhaber Johann, Krautgartner Monika, Alexandrowicz Rainer
Department of Psychiatry, University of Vienna, Austria.
Int J Psychiatry Med. 2003;33(3):257-71. doi: 10.2190/ABXK-FMWG-98YP-D1CU.
To our knowledge, there are no studies investigating the non-cognitive symptoms of patients with dementia such as depression, agitation, or delusions among general hospital inpatients. The aim of this study was to investigate the frequency of such non-cognitive symptoms among medical inpatients and to analyze their impact on the length of hospital stay and on admission to nursing homes.
The sample consisted of 372 elderly inpatients admitted to four internal medical departments (i.e., not including psychiatric wards) in Austria. Patients were investigated by research psychiatrists using the Clinical Interview Schedule. For the analyses of the non-cognitive symptomatology, only marked and severe symptoms were included. To identify predictors for the length of hospital stay and for nursing home placement, multivariate regression procedures were used.
Of all inpatients, 27.4% met criteria for dementia according to DSM-III-R. Of those with dementia, 27.8% had marked or severe non-cognitive symptoms. A diagnosis of dementia markedly increased the risk for nursing home referral and prolonged the duration of inpatient treatment. Among the demented, both, cognitive and non-cognitive symptoms turned out to be significant predictors for nursing home placement and for prolonged duration of acute hospital stay, even when controlling for other independent variables.
Non-cognitive symptoms occur frequently among medical inpatients with dementia and considerably increase both the duration of inpatient treatment and the risk of nursing home placement. Since such non-cognitive symptoms are treatable, they should receive attention from the hospital staff.
据我们所知，尚无研究调查综合医院住院患者中痴呆患者的非认知症状，如抑郁、激越或妄想。本研究的目的是调查内科住院患者中此类非认知症状的发生率，并分析其对住院时间和入住疗养院的影响。
样本包括奥地利四个内科科室（即不包括精神科病房）收治的372名老年住院患者。研究精神科医生使用临床访谈表对患者进行调查。在分析非认知症状时，仅纳入明显和严重的症状。为确定住院时间和入住疗养院的预测因素，采用了多变量回归程序。
在所有住院患者中，27.4%根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）符合痴呆标准。在患有痴呆症的患者中，27.8%有明显或严重的非认知症状。痴呆症诊断显著增加了转诊至疗养院的风险，并延长了住院治疗时间。在痴呆患者中，即使在控制其他自变量后，认知和非认知症状均被证明是入住疗养院和急性住院时间延长的重要预测因素。
痴呆内科住院患者中频繁出现非认知症状，这显著增加了住院治疗时间和入住疗养院的风险。由于此类非认知症状是可治疗的，医院工作人员应予以关注。
