Joosten Etienne, Lemiengre Joke, Nelis Tine, Verbeke Geert, Milisen Koen
Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals K.U. Leuven, Leuven, Belgium.
Gerontology. 2006;52(6):382-5. doi: 10.1159/000095126. Epub 2006 Aug 17.
BACKGROUND/OBJECTIVE: Delirium is a common clinical problem in elderly patients. We aim to investigate whether anaemia is a risk factor for delirium in a hospitalized geriatric population.
During a 5-month prospective study, we investigated 190 elderly patients aged 70 years and older with a baseline Mini-Mental State Examination (short version), Confusion Assessment Method, demographic, clinical and laboratory data.
Thirty-four patients were identified as delirious and 95 as anaemic according to the WHO criteria. Stepwise logistic regression revealed that anaemia (haemoglobin level <12 g/l in women and <13 g/l in men), male sex and a diagnosis of dementia were independent risk factors for delirium in the total study group. After adjustment for sex, age, diagnosis of dementia and dehydration, the odds ratio (OR) for anaemia (2.4; 95 CI = 1.02-5.54) remained significantly associated with delirium. When the study population was classified in groups according to sex, anaemia remained a significant risk factor for delirium in men (OR = 3.7; 95% CI = 1.03-15.6) after adjustment for the multiple variables but not in women (OR = 1.54; 95% CI = 0.48-4.9). When the haemoglobin levels were stratified into sex-specific quartiles, the adjusted OR for delirium for men with a haemoglobin level less than 11.1 g/dl was 13.1 (95% CI = 1.17-146).
Anaemia is an independent risk factor for delirium and adds valuable information to previously validated predictive models in men but not in women and lower haemoglobin levels were associated with higher risk levels.
背景/目的：谵妄是老年患者常见的临床问题。我们旨在调查贫血是否是住院老年人群中谵妄的危险因素。
在一项为期5个月的前瞻性研究中，我们调查了190名70岁及以上的老年患者，收集了基线简易精神状态检查表（简版）、意识错乱评估方法、人口统计学、临床和实验室数据。
根据世界卫生组织标准，34名患者被认定为谵妄患者，95名患者为贫血患者。逐步逻辑回归显示，贫血（女性血红蛋白水平<12 g/l，男性<13 g/l）、男性性别和痴呆诊断是整个研究组中谵妄的独立危险因素。在对性别、年龄、痴呆诊断和脱水进行调整后，贫血的比值比（OR）（2.4；95%置信区间=1.02 - 5.54）仍与谵妄显著相关。当根据性别将研究人群分组时，在对多个变量进行调整后，贫血在男性中仍是谵妄的显著危险因素（OR = 3.7；95%置信区间=1.03 - 15.6），但在女性中不是（OR = 1.54；95%置信区间=0.48 - 4.9）。当将血红蛋白水平按性别特异性四分位数分层时，血红蛋白水平低于11.1 g/dl的男性发生谵妄的调整后OR为13.1（95%置信区间=1.17 - 146）。
贫血是谵妄的独立危险因素，为先前验证的男性预测模型增加了有价值的信息，但对女性并非如此，且血红蛋白水平越低，风险水平越高。
