Holt Rachel, Young John, Heseltine David
Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford, West Yorkshire, UK.
Age Ageing. 2013 Nov;42(6):721-7. doi: 10.1093/ageing/aft120. Epub 2013 Aug 26.
to examine the effect of a multi-component, delirium prevention intervention on rates of incident delirium for patients admitted to specialist elderly care wards.
'before' and 'after' study.
three specialist elderly care wards in a general hospital.
older people admitted as emergencies.
a multi-component delirium prevention intervention that targeted delirium risk factors was implemented by clinical staff. Demographic information and assessments for delirium risk factors were recorded by research staff within 24 h of admission to the ward. New onset (incident) delirium was diagnosed by daily research staff assessments using the Confusion Assessment Method and Delirium Rating Scale-Revised-98.
a total of 436 patients were recruited (249 in the 'before' and 187 in the 'after' group). Incident delirium was significantly reduced ('before' = 13.3%; 'after' = 4.6%; P = 0.006). Delirium severity and duration were significantly reduced in the 'after' group. Mortality, length of stay, activities of daily living score at discharge and new discharge to residential or nursing home rates were similar for both groups.
a multi-component, delirium prevention intervention directed at delirium risk factors and implemented by local clinical staff can reduce incident delirium on specialist elderly care wards.
探讨多组分谵妄预防干预措施对入住老年专科护理病房患者谵妄发生率的影响。
“前后”对照研究。
一家综合医院的三个老年专科护理病房。
因急诊入院的老年人。
临床工作人员实施针对谵妄危险因素的多组分谵妄预防干预措施。研究人员在患者入院病房24小时内记录其人口统计学信息和谵妄危险因素评估情况。每日由研究人员使用意识错乱评估法和修订版谵妄评定量表-98对新发（即发生的）谵妄进行诊断。
共招募436例患者（“前”组249例，“后”组187例）。发生的谵妄显著减少（“前”组=13.3%；“后”组=4.6%；P = 0.006）。“后”组谵妄严重程度和持续时间显著降低。两组的死亡率、住院时间、出院时日常生活活动评分以及转至养老院或疗养院的新出院率相似。
由当地临床工作人员实施的、针对谵妄危险因素的多组分谵妄预防干预措施可降低老年专科护理病房中发生的谵妄。
