DeCrane Susan K, Culp Kennith R, Wakefield Bonnie
Purdue University School of Nursing, 502 North University Street, West Lafayette, IN 47907-2069, USA.
Clin Nurs Res. 2011 Nov;20(4):404-21. doi: 10.1177/1054773811419497. Epub 2011 Aug 24.
This study used data from the Delirium Among the Elderly in Rural Long-Term Care Facilities Study and data from the National Death Index (NDI) to examine mortality among 320 individuals. Individuals were grouped into noncases, subsyndromal cases, hypoactive delirium, hyperactive delirium, and mixed delirium on the basis of scoring using the Confusion Assessment Method (CAM), NEECHAM Scale, Mini-Mental State Examination (MMSE), Clinical Assessment of Confusion-A (CAC-A), and Vigilance A instruments. Risk ratios of mortality using "days of survival" did not reach statistical significance (α = .05) for any subgroup. Underlying cause of death (UCD) using International Classification of Disease, 10th version (ICD-10), showed typical UCD among older adults. There appeared to be clinical differences in UCD between delirium subgroups. Findings supported the conclusion that careful monitoring of patients with delirium and subsyndromal delirium is needed to avoid complications and injuries that could increase mortality.
本研究使用了农村长期护理机构老年人谵妄研究的数据以及国家死亡指数（NDI）的数据，以调查320名个体的死亡率。根据使用混乱评估方法（CAM）、NEECHAM量表、简易精神状态检查表（MMSE）、混乱临床评估-A（CAC-A）和警觉性-A工具进行的评分，将个体分为非病例、亚综合征病例、活动减退型谵妄、活动亢进型谵妄和混合型谵妄。对于任何亚组，使用“存活天数”计算的死亡率风险比均未达到统计学显著性（α = 0.05）。使用国际疾病分类第10版（ICD-10）确定的潜在死因（UCD）显示，老年人中存在典型的UCD。谵妄亚组之间的UCD似乎存在临床差异。研究结果支持以下结论，即需要对谵妄和亚综合征性谵妄患者进行仔细监测，以避免可能增加死亡率的并发症和伤害。
