Graduate Entry Medical School, , University of Limerick, Ireland.
J Neurol Neurosurg Psychiatry. 2014 Feb;85(2):207-13. doi: 10.1136/jnnp-2012-304334. Epub 2013 Jan 25.
Delirium is a complex neuropsychiatric syndrome that impacts adversely upon patient outcomes and healthcare outcomes. Delirium occurs in approximately one in five hospitalised patients and is especially common in the elderly and patients who are highly morbid and/or have pre-existing cognitive impairment. However, efforts to improve management of delirium are hindered by gaps in our knowledge and issues that reflect a disparity between existing knowledge and real-world practice. This review focuses on evidence that can assist in prevention, earlier detection and more timely and effective pharmacological and non-pharmacological management of emergent cases and their aftermath. It points towards a new approach to delirium care, encompassing laboratory and clinical aspects and health services realignment supported by health managers prioritising delirium on the healthcare change agenda. Key areas for future research and service organisation are outlined in a plan for improved delirium care across the range of healthcare settings and patient populations in which it occurs.
谵妄是一种复杂的神经精神综合征，会对患者的预后和医疗结果产生不利影响。约五分之一的住院患者会发生谵妄，尤其是老年人和病情严重以及/或存在认知障碍的患者。然而，由于我们对其认识不足以及现有知识与实际情况之间的差距，改善谵妄管理的努力受到了阻碍。本综述重点关注有助于预防、更早发现以及更及时、有效的药物和非药物治疗突发病例及其后果的证据。它为谵妄护理提供了一种新方法，包括实验室和临床方面，以及卫生管理者支持的卫生服务调整，将谵妄列为医疗保健变革议程上的优先事项。在涉及发生谵妄的各种医疗环境和患者群体中，提出了改善谵妄护理的未来研究和服务组织的重点领域。
