University of Antwerp, Division of Nursing Science and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium, Artesis University College of Antwerp, Department of Health Sciences, J. De Boeckstraat 10, 2170 Merksem, Belgium.
J Clin Nurs. 2009 Dec;18(23):3349-57. doi: 10.1111/j.1365-2702.2009.02933.x. Epub 2009 Sep 4.
This research studied the long term outcome of intensive care delirium defined as mortality and quality of life at three and six months after discharge of the intensive care unit.
Delirium in the intensive care unit is known to result in worse outcomes. Cognitive impairment, a longer stay in the hospital or in the intensive care unit and a raised mortality have been reported.
A prospective cohort study.
A population of 105 consecutive patients was included during the stay at the intensive care unit in July-August 2006. The population was assessed once a day for delirium using the NEECHAM Confusion Scale and the CAM-ICU. Patients were visited at home by a nurse researcher to assess the quality of life using the Medical Outcomes Study Short-Form General Health Survey at three and six months after discharge of the intensive care unit. Delirious and non delirious patients were compared for mortality and quality of life.
Compared to the non delirious patients, more delirious patients died. The total study population discharged from the intensive care unit, scored lower for quality of life in all domains compared to the reference population. The domains showed lower results for the delirious patients compared to the non delirious patients.
Mortality was higher in delirious patients. All patients showed lower values for the quality of life at three months. The delirious patients showed lower results than the non delirious patients.
Nurses are the first caregivers to observe patients. The fluctuating delirious process is often not noticed. Long term effects are not visible to the interdisciplinary team in the hospital. This paper would like to raise the awareness of professionals for long term outcomes for patients having experienced delirium in the intensive care unit.
本研究旨在探讨 ICU 谵妄的长期结局，即 ICU 出院后 3 个月和 6 个月的死亡率和生活质量。
已知 ICU 中的谵妄会导致更差的结果。据报道，认知障碍、住院时间或 ICU 时间延长以及死亡率升高。
前瞻性队列研究。
在 2006 年 7 月至 8 月期间，对 105 例连续入住 ICU 的患者进行了研究。每天使用 NEECHAM 意识模糊量表和 CAM-ICU 对患者进行一次谵妄评估。由护士研究人员对患者进行家访，以评估 ICU 出院后 3 个月和 6 个月的生活质量，使用医疗结局研究短式健康调查问卷。对谵妄患者和非谵妄患者进行死亡率和生活质量比较。
与非谵妄患者相比，谵妄患者的死亡率更高。与参考人群相比，所有从 ICU 出院的患者在所有领域的生活质量评分均较低。与非谵妄患者相比，谵妄患者在各领域的得分均较低。
谵妄患者的死亡率更高。所有患者在 3 个月时的生活质量值均较低。谵妄患者的结果低于非谵妄患者。
护士是观察患者的第一照顾者。波动的谵妄过程往往不会被注意到。医院的跨学科团队无法看到长期影响。本文旨在提高专业人员对 ICU 谵妄患者长期结局的认识。
