Laurila Jouko V, Laakkonen Marja-Liisa, Tilvis Reijo S, Pitkala Kaisu H
Departments of Internal Medicine and Geriatrics [corrected] Helsinki University Central Hospital, Finland.
J Psychosom Res. 2008 Sep;65(3):249-54. doi: 10.1016/j.jpsychores.2008.05.026.
The aim of this study was to assess the possible predisposing aetiologic and short-term precipitating factors for delirium in acutely ill hospital patients with a heavy burden of comorbidities and medications.
Eighty-seven consecutive patients with acute delirium admitted to a general medicine unit were thoroughly examined, and the predisposing and precipitating factors of their delirium were assessed.
In this population, an average of 5.2 predisposing factors and 3.0 potential precipitating factors for delirium was revealed, meaning an average of over eight possible aetiological causes for each patient. The most common precipitating factors were infections (n=72), metabolic abnormalities (n=52), adverse drug effects (n=41), and cardiovascular events (n=38). In addition, a number of very rare conditions were diagnosed after thorough assessments.
Geriatric patients with acute delirium typically present with several concomitant predisposing factors for delirium exposing them to high vulnerability for the syndrome. In most patients, a number of possible etiological causes for delirium can be identified after a careful assessment, but their true pathogenetic pathway to the syndrome is unclear.
本研究旨在评估合并症和用药负担较重的急性病住院患者发生谵妄的可能诱发病因及短期促发因素。
对连续收治到普通内科病房的87例急性谵妄患者进行全面检查，并评估其谵妄的诱发因素和促发因素。
在该人群中，平均发现5.2个谵妄诱发因素和3.0个潜在促发因素，这意味着每位患者平均有超过8种可能的病因。最常见的促发因素是感染（n = 72）、代谢异常（n = 52）、药物不良反应（n = 41）和心血管事件（n = 38）。此外，经过全面评估后诊断出了一些非常罕见的情况。
急性谵妄的老年患者通常存在多种伴随的谵妄诱发因素，使他们极易患上该综合征。在大多数患者中，经过仔细评估可以确定一些谵妄的可能病因，但它们导致该综合征的确切发病机制尚不清楚。
