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使用非药物干预预防急性医院中的谵妄。

Preventing delirium in an acute hospital using a non-pharmacological intervention.

机构信息

Escuela de Medicina, Universidad de Valparaiso, Valparaiso, Chile.

出版信息

Age Ageing. 2012 Sep;41(5):629-34. doi: 10.1093/ageing/afs060. Epub 2012 May 15.

Abstract

BACKGROUND

delirium is a clinical syndrome associated with multiple short and long-term complications and therefore prevention is an essential part of its management. This study was designed to assess the efficacy of multicomponent intervention in delirium prevention.

METHODS

a total of 287 hospitalised patients at intermediate or high risk of developing delirium were randomised to receive a non-pharmacological intervention delivered by family members (144 patients) or standard management (143 patients). The primary efficacy outcome was the occurrence of delirium at any time during the course of hospitalisation. Three validated observers performed the event adjudication by using the confusion assessment method screening instrument.

RESULTS

there were no significant differences in the baseline characteristics between the two groups. The primary outcome occurred in 5.6% of the patients in the intervention group and in 13.3% of the patients in the control group (relative risk: 0.41; confidence interval: 0.19-0.92; P = 0.027).

CONCLUSION

the results of this study show that there is a benefit in the non-pharmacological prevention of delirium using family members, when compared with standard management of patients at risk of developing this condition.

摘要

背景

谵妄是一种与多种短期和长期并发症相关的临床综合征,因此预防是其治疗的重要组成部分。本研究旨在评估多组分干预在预防谵妄中的疗效。

方法

共招募了 287 名处于发生谵妄中、高风险的住院患者,将其随机分为接受家庭成员提供的非药物干预(144 例)或标准管理(143 例)的两组。主要疗效结局是在住院期间任何时间发生谵妄的情况。三名经过验证的观察者使用意识模糊评估方法筛查工具进行事件裁决。

结果

两组患者的基线特征无显著差异。干预组的主要结局发生率为 5.6%,对照组为 13.3%(相对风险:0.41;置信区间:0.19-0.92;P=0.027)。

结论

与对有发生该疾病风险的患者进行标准管理相比,使用家庭成员进行非药物性谵妄预防具有益处。

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