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老年人谵妄:临床综述。

Delirium in the elderly: a clinical review.

机构信息

Mental Health Services For Older People, Plymouth Teaching Primary Care Trust, Plympton Hospital, Plymouth, UK.

出版信息

Postgrad Med J. 2009 Aug;85(1006):405-13. doi: 10.1136/pgmj.2008.072025.

Abstract

Delirium is a common condition in the elderly, affecting up to 30% of all older patients admitted to hospital. There is a particularly high risk of delirium in surgical inpatients, especially following operations for hip fracture or vascular surgery, but also for patients in the intensive care unit. Patients with delirium have higher morbidity and mortality rates, higher re-admission rates, and a greater risk of long term institutionalisation care, thereby having a significant impact on both health and social care expenditure. Delirium frequently goes unrecognised by clinicians and is often inadequately managed. Recent evidence suggests that a better understanding and knowledge of delirium among health care professionals can lead to early detection, the reduction of modifiable risk factors, and better management of the condition in the acute phase. Many cases of delirium are potentially preventable, and primary and secondary care services should be taking active steps in order to do prevent this condition.

摘要

谵妄是老年人中常见的一种病症,影响到高达 30%的所有住院老年患者。在外科住院患者中,尤其是在髋部骨折或血管手术后的患者,以及在重症监护病房的患者中,谵妄的风险特别高。患有谵妄的患者有更高的发病率和死亡率、更高的再入院率,以及长期住院护理的风险更大,因此对医疗保健和社会保健支出都有重大影响。谵妄经常被临床医生忽视,且往往管理不当。最近的证据表明,医疗保健专业人员对谵妄有更好的理解和认识,可以导致早期发现、减少可改变的危险因素,并在急性期更好地管理病情。许多谵妄病例是可以预防的,初级和二级保健服务应采取积极措施来预防这种情况。

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