Travers C, Byrne G J, Pachana N A, Klein K, Gray L
Queensland Dementia Training Study Centre, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
Curr Gerontol Geriatr Res. 2013;2013:284780. doi: 10.1155/2013/284780. Epub 2013 Sep 12.
Objectives. Australian data regarding delirium in older hospitalized patients are limited. Hence, this study aimed to determine the prevalence and incidence of delirium among older patients admitted to Australian hospitals and assess associated outcomes. Method. A prospective observational study (n = 493) of patients aged ≥70 years admitted to four Australian hospitals was undertaken. Trained research nurses completed comprehensive geriatric assessments using standardized instruments including the Confusion Assessment Method to assess for delirium. Nurses also visited the wards daily to assess for incident delirium and other adverse outcomes. Diagnoses of dementia and delirium were established through case reviews by independent physicians. Results. Overall, 9.7% of patients had delirium at admission and a further 7.6% developed delirium during the hospital stay. Dementia was the most important predictor of delirium at (OR = 3.18, 95% CI: 1.65-6.14) and during the admission (OR = 4.82; 95% CI: 2.19-10.62). Delirium at and during the admission predicted increased in-hospital mortality (OR = 5.19, 95% CI: 1.27-21.24; OR = 31.07, 95% CI: 9.30-103.78). Conclusion. These Australian data confirm that delirium is a common and serious condition among older hospital patients. Hospital clinicians should maintain a high index of suspicion for delirium in older patients.
目的。关于澳大利亚老年住院患者谵妄的数据有限。因此，本研究旨在确定入住澳大利亚医院的老年患者中谵妄的患病率和发病率，并评估相关结局。方法。对入住四家澳大利亚医院的年龄≥70岁的患者进行了一项前瞻性观察性研究（n = 493）。训练有素的研究护士使用标准化工具（包括用于评估谵妄的混乱评估方法）完成全面的老年评估。护士还每天查房以评估新发谵妄和其他不良结局。痴呆和谵妄的诊断由独立医生通过病例审查确定。结果。总体而言，9.7%的患者入院时患有谵妄，另有7.6%的患者在住院期间发生谵妄。痴呆是入院时（比值比 = 3.18，95%置信区间：1.65 - 6.14）和住院期间（比值比 = 4.82；95%置信区间：2.19 - 10.62）谵妄的最重要预测因素。入院时和住院期间的谵妄预示着住院死亡率增加（比值比 = 5.19，95%置信区间：1.27 - 21.24；比值比 = 31.07，95%置信区间：9.30 - 103.78）。结论。这些澳大利亚的数据证实，谵妄在老年住院患者中是一种常见且严重的情况。医院临床医生应对老年患者的谵妄保持高度怀疑指数。
