Francis J, Martin D, Kapoor W N
Division of General Internal Medicine, Unversity of Pittsburgh, School of Medicine, PA.
JAMA. 1990 Feb 23;263(8):1097-101.
The prevalence, risk factors, and outcomes of delirium were studied in 229 elderly patients. Fifty patients (22%) met criteria for delirium; nondelirious elderly constituted the control group. Abnormal sodium levels, illness severity, dementia, fever or hypothermia, psychoactive drug use, and azotemia were associated with risk of delirium. Patients with three or more risk factors had a 60% rate of delirium. Delirious patients stayed 12.1 days in the hospital vs 7.2 days for controls and were more likely to die (8% vs 1%) or be institutionalized (16% vs 3%). Illness severity predicted 6-month mortality, but the effect of delirium was not significant. Delirium occurs commonly in hospitalized elderly, is associated with chronic and acute problems, and identifies elderly at risk for death, longer hospitalization, and institutionalization. The increased mortality associated with delirium appears to be explained by greater severity of illness.
对229名老年患者的谵妄患病率、危险因素及转归进行了研究。50名患者（22%）符合谵妄标准；未发生谵妄的老年患者作为对照组。钠水平异常、疾病严重程度、痴呆、发热或体温过低、使用精神活性药物及氮质血症与谵妄风险相关。有三个或更多危险因素的患者谵妄发生率为60%。发生谵妄的患者住院时间为12.1天，而对照组为7.2天，且更有可能死亡（8%对1%）或被送入养老院（16%对3%）。疾病严重程度可预测6个月死亡率，但谵妄的影响并不显著。谵妄在住院老年患者中很常见，与慢性和急性问题相关，并可识别出有死亡、住院时间延长及被送入养老院风险的老年人。与谵妄相关的死亡率增加似乎可由疾病更严重来解释。
