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本文引用的文献

1
Profiling disability within nursing homes: a census-based approach.疗养院残疾情况剖析：基于普查的方法。
Age Ageing. 2007 Mar;36(2):209-13. doi: 10.1093/ageing/afl185. Epub 2007 Feb 12.
2
Multicomponent intervention strategies for managing delirium in hospitalized older people: systematic review.用于管理住院老年人谵妄的多组分干预策略：系统评价
J Adv Nurs. 2005 Oct;52(1):79-90. doi: 10.1111/j.1365-2648.2005.03557.x.
3
Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.厘清残疾、虚弱和共病的概念：对改善目标定位和护理的启示。
J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63. doi: 10.1093/gerona/59.3.m255.
4
The Emergency Severity Index (version 3) 5-level triage system scores predict ED resource consumption.急诊严重程度指数（第3版）5级分诊系统评分可预测急诊科资源消耗。
J Emerg Nurs. 2004 Feb;30(1):22-9. doi: 10.1016/j.jen.2003.11.004.
5
Delirium in elderly patients.老年患者的谵妄
Am J Geriatr Psychiatry. 2004 Jan-Feb;12(1):7-21.
6
The effect of mental status screening on the care of elderly emergency department patients.精神状态筛查对老年急诊科患者护理的影响。
Ann Emerg Med. 2003 May;41(5):678-84. doi: 10.1067/mem.2003.152.
7
Delirium predicts 12-month mortality.谵妄可预测12个月死亡率。
Arch Intern Med. 2002 Feb 25;162(4):457-63. doi: 10.1001/archinte.162.4.457.
8
Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).机械通气患者的谵妄：重症监护病房意识模糊评估法（CAM-ICU）的有效性和可靠性
JAMA. 2001 Dec 5;286(21):2703-10. doi: 10.1001/jama.286.21.2703.
9
Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value?多组分靶向干预预防老年住院患者谵妄：其经济价值是什么？
Med Care. 2001 Jul;39(7):740-52. doi: 10.1097/00005650-200107000-00010.
10
Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).危重症患者谵妄的评估：重症监护病房意识模糊评估法（CAM-ICU）的验证
Crit Care Med. 2001 Jul;29(7):1370-9. doi: 10.1097/00003246-200107000-00012.

急诊科所见养老院患者的谵妄。

Delirium in the nursing home patients seen in the emergency department.

作者信息

Han Jin H, Morandi Alessandro, Ely E Wesley, Callison Clay, Zhou Chuan, Storrow Alan B, Dittus Robert S, Habermann Ralf, Schnelle John

机构信息

Department of Emergency Medicine, Vanderbilt University Medical Center, 703 Oxford House, Nashville, TN 37232-4700, USA.

出版信息

J Am Geriatr Soc. 2009 May;57(5):889-94. doi: 10.1111/j.1532-5415.2009.02219.x.

DOI:10.1111/j.1532-5415.2009.02219.x
PMID:19484845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4970317/
Abstract

OBJECTIVES

To determine whether nursing home patients are more likely than non-nursing home patients to present to the emergency department (ED) with delirium and to explore how variations in their delirium risk factor profiles contribute to this relationship.

DESIGN

Prospective cross-sectional study.

SETTING

Tertiary care academic ED.

PARTICIPANTS

Three hundred forty-one English-speaking patients aged 65 and older.

MEASUREMENTS

Delirium status was determined using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) administered by trained research assistants. Multivariable logistic regression was used to determine whether nursing home residence was independently associated with delirium. Adjusted odds ratios (ORs) with their 95% confidence intervals (95% CIs) were reported.

RESULTS

Of the 341 patients enrolled, 58 (17.0%) resided in a nursing home and 38 (11.1%) were considered to have delirium in the ED. Of the 58, (22 (37.9%) nursing home patients and 16 of 283 (5.7%) non-nursing home patients had delirium; unadjusted OR=10.2, 95% CI=4.9-21.2). After adjusting for dementia, a Katz activity of daily living score less than or equal to 4, hearing impairment, and the presence of systemic inflammatory response syndrome, nursing home residence was independently associated with delirium in the ED (adjusted OR=4.2, 95% CI=1.8-9.7).

CONCLUSION

In the ED setting, nursing home patients were more likely to present with delirium, and this relationship persisted after adjusting for delirium risk factors.

摘要

目的

确定疗养院患者与非疗养院患者相比，是否更有可能因谵妄而前往急诊科就诊，并探讨其谵妄风险因素概况的差异如何导致这种关系。

设计

前瞻性横断面研究。

地点

三级医疗学术急诊科。

参与者

341名65岁及以上讲英语的患者。

测量

谵妄状态通过由训练有素的研究助理使用重症监护病房谵妄评估方法（CAM-ICU）来确定。多变量逻辑回归用于确定居住在疗养院是否与谵妄独立相关。报告了调整后的比值比（OR）及其95%置信区间（95%CI）。

结果

在纳入的341名患者中，58名（17.0%）居住在疗养院，38名（11.1%）在急诊科被认为患有谵妄。在这58名患者中，22名（37.9%）疗养院患者和283名中的16名（5.7%）非疗养院患者患有谵妄；未调整的OR=10.2，95%CI=4.9-21.2。在调整痴呆、日常生活活动能力Katz评分小于或等于4、听力障碍和全身炎症反应综合征的存在后，居住在疗养院与急诊科谵妄独立相关（调整后的OR=4.2，95%CI=1.8-9.7）。

结论

在急诊科环境中，疗养院患者更有可能出现谵妄，并且在调整谵妄风险因素后这种关系仍然存在。