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[老年人谵妄]

[Delirium in the elderly].

作者信息

Gogol Manfred

机构信息

Klinik für Geriatrie, Krankenhaus Lindenbrunn, Lindenbrunn 1, 31863, Coppenbrügge, Germany.

出版信息

Z Gerontol Geriatr. 2008 Dec;41(6):431-9. doi: 10.1007/s00391-008-0019-z. Epub 2008 Oct 30.

Abstract

Delirium is a common, serious medical and often life-threatening condition in elderly in-patients. Delirium can develop primarily or secondarily related to other medical conditions and lead to hospital admission. The pathogenesis is still not fully known and is usually addressed as multifactorial. Alterations in neurotransmitters have a key role in this process. The incidence varies by setting up to 90%. Delirium is associated with increased short- and long-term mortality, iatrogenic complications, functional decline, and future development of cognitive impairment or dementia. Delirium is also associated with longer hospital stays, higher hospital and total health system costs, and an increasing rate of nursing home admissions. A structured diagnostic and therapeutic process is recommended. Delirium should become a quality indicator for hospital medicine; however, many research questions still exist.

摘要

谵妄是老年住院患者中常见、严重且往往危及生命的病症。谵妄可原发性或继发性地与其他病症相关,并导致住院治疗。其发病机制仍未完全明确,通常被认为是多因素的。神经递质的改变在这一过程中起关键作用。发病率因环境不同可达90%。谵妄与短期和长期死亡率增加、医源性并发症、功能衰退以及认知障碍或痴呆的未来发展相关。谵妄还与住院时间延长、医院和整个卫生系统成本增加以及疗养院入住率上升有关。建议采用结构化的诊断和治疗流程。谵妄应成为医院医学的质量指标;然而,仍存在许多研究问题。

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