Cole Martin G, Bailey Robert, Bonnycastle Michael, McCusker Jane, Fung Shek, Ciampi Antonio, Belzile Eric
Department of Psychiatry, McGill University; and St Mary's Hospital Center, Montreal, Quebec, Canada.
St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada.
Int J Geriatr Psychiatry. 2016 May;31(5):544-50. doi: 10.1002/gps.4372. Epub 2015 Nov 2.
To determine the frequencies of full, partial and no recovery from subsyndromal delirium (SSD) in older hospital inpatients. A secondary objective was to compare the recovery status of patients with SSD or delirium.
SSD was defined as acute onset of one or more Confusion Assessment Method core symptoms of delirium (fluctuation, inattention, disorganized thinking and altered level of consciousness) not meeting criteria for delirium and not progressing to delirium. The recovery status of medical or surgical inpatients aged 65 and older with SSD was assessed approximately 1 and 3 months after enrolment. Primary outcome categories were full recovery (no core symptoms of delirium), partial recovery (presence of one or more core symptoms but fewer symptoms than at enrolment), no recovery (same number of core symptoms as at enrolment) or death. Nominal logistic regression was used to compare the recovery status of patients with SSD or delirium.
Twenty-eight patients with SSD were enrolled. At the first follow-up, the frequencies of full, partial and no recovery and death were 40%, 12%, 32% and 16%, respectively; at the second follow-up, the frequencies were 54%, 8%, 21% and 17%, respectively. The frequency of full recovery was much higher in patients with SSD than delirium.
Small study sample size notwithstanding, the majority (54%) of patients with SSD recovered fully, but a substantial proportion (29%) had a protracted course. It may be important to monitor the longer-term course of SSD and develop strategies to ensure full recovery in all patients.
确定老年住院患者中，亚综合征谵妄（SSD）完全康复、部分康复和未康复的频率。次要目的是比较SSD患者与谵妄患者的康复状况。
SSD定义为出现一项或多项谵妄的意识错乱评估法核心症状（波动、注意力不集中、思维紊乱和意识水平改变），但未达到谵妄标准且未进展为谵妄。对65岁及以上患有SSD的内科或外科住院患者，在入组后约1个月和3个月评估其康复状况。主要结局类别为完全康复（无谵妄核心症状）、部分康复（存在一项或多项核心症状，但症状少于入组时）、未康复（核心症状数量与入组时相同）或死亡。采用名义逻辑回归比较SSD患者与谵妄患者的康复状况。
共纳入28例SSD患者。首次随访时，完全康复、部分康复、未康复和死亡的频率分别为40%、12%、32%和16%；第二次随访时，频率分别为54%、8%、21%和17%。SSD患者的完全康复频率远高于谵妄患者。
尽管研究样本量较小，但大多数（54%）SSD患者实现了完全康复，但仍有相当比例（29%）病程迁延。监测SSD的长期病程并制定策略以确保所有患者完全康复可能很重要。
