Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, A.O. San Paolo-Polo Universitario, Milan, Italy.
Best Pract Res Clin Anaesthesiol. 2012 Sep;26(3):311-26. doi: 10.1016/j.bpa.2012.07.001.
Delirium, defined as an acute fluctuating change in mental state, with consciousness and cognitive impairment, has been found to have a high incidence in hospitalised patients, as well as being associated with increased morbidity and mortality, prolonged stays in the intensive care unit (ICU) and in hospital and higher costs. However, delirium is not easy to detect, since its diagnosis is mainly clinical. Yet the importance of early diagnosis and possible prevention in the different clinical scenarios is clear, to improve patient prognosis. This review provides a practical approach to delirium management through: (a) its classification and diagnosis utilising validated tools and (b) the use of non-pharmacological protocols and of an early prediction model to identify high-risk patients, who are more likely to benefit from pharmacological prophylaxis.
谵妄是一种以意识和认知障碍为特征的急性波动性精神状态改变，研究发现其在住院患者中的发病率较高，并且与发病率和死亡率增加、重症监护病房（ICU）和住院时间延长以及更高的成本相关。然而，谵妄并不容易被发现，因为其诊断主要基于临床症状。然而，在不同的临床情况下，早期诊断和可能的预防对于改善患者预后至关重要。本综述通过以下方法为谵妄的管理提供了一种实用方法：（a）利用经过验证的工具对其进行分类和诊断；（b）使用非药物治疗方案和早期预测模型来识别高风险患者，这些患者更有可能从药物预防中获益。
