Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Clínica del Dolor y Cuidados Paliativos, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Rev Psiquiatr Salud Ment. 2014 Jan-Mar;7(1):48-58. doi: 10.1016/j.rpsm.2013.05.001. Epub 2013 Jul 31.
Delirium in palliative care patients is common and its diagnosis and treatment is a major challenge. Our objective was to perform a literature analysis in two phases on the recent scientific evidence (2007-2012) on the diagnosis and treatment of delirium in adults receiving palliative care. In phase 1 (descriptive studies and narrative reviews) 133 relevant articles were identified: 73 addressed the issue of delirium secondarily, and 60 articles as the main topic. However, only 4 prospective observational studies in which delirium was central were identified. Of 135 articles analysed in phase 2 (clinical trials or descriptive studies on treatment of delirium in palliative care patients), only 3 were about prevention or treatment: 2 retrospective studies and one clinical trial on multicomponent prevention in cancer patients. Much of the recent literature is related to reviews on studies conducted more than a decade ago and on patients different to those receiving palliative care. In conclusion, recent scientific evidence on delirium in palliative care is limited and suboptimal. Prospective studies are urgently needed that focus specifically on this highly vulnerable population.
在姑息治疗患者中，谵妄很常见，其诊断和治疗是一个主要的挑战。我们的目的是在两个阶段对最近的科学证据（2007-2012 年）进行文献分析，以了解成人姑息治疗患者谵妄的诊断和治疗。在第一阶段（描述性研究和叙述性综述），共确定了 133 篇相关文章：73 篇文章是关于谵妄的次要问题，60 篇文章是关于谵妄的主要问题。然而，只有 4 篇前瞻性观察性研究将谵妄作为研究重点。在第二阶段（姑息治疗患者谵妄治疗的临床研究或描述性研究）共分析了 135 篇文章，只有 3 篇文章涉及预防或治疗：2 篇回顾性研究和一篇关于癌症患者多组分预防的临床试验。最近的许多文献都与十多年前的研究综述以及与接受姑息治疗的患者不同的患者有关。总之，姑息治疗患者谵妄的最近科学证据有限且不理想。迫切需要进行专门针对这一高度脆弱人群的前瞻性研究。
