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入住普通内科的老年患者的谵妄

Delirium in older patients admitted to general internal medicine.

作者信息

Edlund Agneta, Lundström Maria, Karlsson Stig, Brännström Benny, Bucht Gösta, Gustafson Yngve

机构信息

Department of Medicine and Rehabilitation, Piteå River Valley Hospital, Piteå, Sweden.

出版信息

J Geriatr Psychiatry Neurol. 2006 Jun;19(2):83-90. doi: 10.1177/0891988706286509.

Abstract

Delirium on the day of admission to general internal medicine wards was studied in 400 consecutive patients aged 70 years and above regarding occurrence, associated factors, clinical profile, length of hospital stay, and mortality. The patients were assessed using the Organic Brain Syndrome Scale and the Mini-Mental State Examination, and delirium was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (4th ed) criteria. Delirium on the day of admission occurred in 31.3% of the patients and was independently associated with old age, fever on the day of admission (> or = 38 degrees C), treatment with neuroleptics, impaired vision, male sex, and previous stroke. Delirious patients had longer hospital stay (15.4 vs 9.5 days, P < .001), a higher mortality rate during hospitalization (11/125 vs 5/275, P < .001), and a higher 1-year mortality rate (45/125 vs 55/275, P = .001). Delirium is a common complication with often easily identified causes, and it has a serious impact on outcome for older medical patients.

摘要

对400名70岁及以上连续入住普通内科病房的患者进行了入院当天谵妄情况的研究,内容涉及发生率、相关因素、临床特征、住院时间及死亡率。使用器质性脑综合征量表和简易精神状态检查表对患者进行评估,并根据《精神疾病诊断与统计手册》(第4版)标准诊断谵妄。入院当天谵妄的发生率为31.3%,且与高龄、入院当天发热(≥38℃)、使用抗精神病药物治疗、视力受损、男性及既往中风独立相关。谵妄患者的住院时间更长(15.4天对9.5天,P<.001),住院期间死亡率更高(125例中有11例对275例中有5例,P<.001),1年死亡率也更高(125例中有45例对275例中有55例,P=.001)。谵妄是一种常见并发症,病因通常易于识别,且对老年内科患者的预后有严重影响。

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