Geriatric Research, Education and Clinical Center, St. Louis VA Medical Center, and Department of Internal Medicine & Division of Geriatrics, Saint Louis University School of Medicine, 1402 S. Grand Blvd., St. Louis, MO 63104, USA.
J Gerontol A Biol Sci Med Sci. 2010 Dec;65(12):1387-92. doi: 10.1093/gerona/glq136. Epub 2010 Aug 2.
Patients with delirium, compared with those without, are at increased risk for loss of function, longer hospital stays, and increased mortality. We studied the effect that an Acute Care of the Elderly Unit, which includes a delirium room, has on patients with delirium.
Retrospective observational study. Charts of 148 patients (≥65 years) admitted to an Acute Care of the Elderly Unit with a delirium room during a 4-month period were reviewed. Delirium on admission (prevalence) was based on physician-performed Confusion Assessment Method; delirium during hospital stay (incidence) was based on nurse-performed Confusion Assessment Method. Patients with delirium were compared with those without delirium regarding change in function between admission and discharge (activities of daily living), hospital length of stay, and mortality.
The prevalence of delirium was 16.2% (24/148), and the incidence was 16.1% (20/124). There were no significant differences between delirious and non-delirious patients in demographics or comorbidity scores. A significant interaction effect (p < .001) indicated improved activities of daily living (mean ± SD; scale 0-12) between admission and discharge among delirious patients (4.1 ± 4.6 and 6.1 ± 3.9) compared with non-delirious patients (7.4 ± 4.7 and 6.9 ± 4.5). There were no differences between delirious and non-delirious patients with reference to mean length of stay (6.4 ± 3.1 vs 5.9 ± 3.6 days, respectively; p = .461) and mortality (2 [4.5%] versus 2 [1.9%], respectively; p = .582).
Although this study sample was small, the results suggest that an Acute Care of the Elderly Unit with a delirium room may improve function among delirious patients and may equalize other outcomes compared with non-delirious patients.
与无谵妄的患者相比，谵妄患者的功能丧失、住院时间延长和死亡率增加的风险更高。我们研究了包括谵妄病房在内的老年急性护理病房对谵妄患者的影响。
回顾性观察性研究。回顾了在 4 个月期间入住老年急性护理病房且有谵妄病房的 148 名（≥65 岁）患者的病历。入院时的谵妄（患病率）基于医生进行的意识混乱评估方法（Confusion Assessment Method）；住院期间的谵妄（发病率）基于护士进行的意识混乱评估方法。比较了有谵妄和无谵妄患者在入院和出院之间的功能变化（日常生活活动）、住院时间和死亡率。
谵妄的患病率为 16.2%（24/148），发病率为 16.1%（20/124）。有谵妄和无谵妄患者在人口统计学或合并症评分方面无显著差异。显著的交互效应（p<.001）表明，与无谵妄患者相比（分别为 7.4 ± 4.7 和 6.9 ± 4.5），谵妄患者的日常生活活动（0-12 分制）在入院和出院时均有显著改善（分别为 4.1 ± 4.6 和 6.1 ± 3.9）。有谵妄和无谵妄患者的平均住院时间（分别为 6.4 ± 3.1 和 5.9 ± 3.6 天，p=0.461）和死亡率（分别为 2[4.5%]和 2[1.9%]，p=0.582）无差异。
尽管本研究样本较小，但结果表明，老年急性护理病房设有谵妄病房可能会改善谵妄患者的功能，并且可能与非谵妄患者的其他结果相当。
