Heriot Natalie R, Levinson Michele R, Mills Amber C, Khine Thinn Thinn, Gellie Anthea L, Sritharan Gaya
Cabrini Institute, Cabrini-Monash Department of Medicine, Cabrini Hospital, Malvern, VIC, Australia.
Cabrini Institute, Cabrini-Monash Department of Medicine, Cabrini Hospital, Malvern, VIC, Australia; Monash University, VIC, Australia.
Intensive Crit Care Nurs. 2017 Feb;38:10-17. doi: 10.1016/j.iccn.2016.07.002. Epub 2016 Sep 3.
To determine the incidence of delirium in elderly intensive care patients and to compare incidence using two retrospective chart-based diagnostic methods and a hospital reporting measure (ICD-10).
Retrospective study.
An ICU in a large metropolitan private hospital in Melbourne, Australia.
English-speaking participants (n=348) 80+ years, admitted to ICU for >24 hours.
Medical files of ICU patients admitted October 2009-October 2012 were retrospectively assessed for delirium using the Inouye chart review method, DSM-IV diagnostic criteria and ICD-10 coding data. General patient characteristics, first onset of delirium symptoms, source of delirium information, administration of delirium medication, hospital and ICU length of stay, 90 day mortality were documented. Delirium was found in 11-29% of patients, the highest incidence identified by chart review. Patients diagnosed with delirium had higher 90 day mortality, and those meeting criteria for all three methods had longer hospital and ICU length of stay.
ICU delirium in the elderly is often under-reported and strategies are needed to improve staff education and diagnosis.
确定老年重症监护患者谵妄的发生率，并使用两种基于回顾性图表的诊断方法和一种医院报告指标（ICD - 10）比较发生率。
回顾性研究。
澳大利亚墨尔本一家大型都市私立医院的重症监护病房。
80岁及以上讲英语的参与者（n = 348），入住重症监护病房超过24小时。
对2009年10月至2012年10月入住重症监护病房患者的病历，采用Inouye图表回顾法、DSM - IV诊断标准和ICD - 10编码数据对谵妄进行回顾性评估。记录患者一般特征、谵妄症状的首次出现、谵妄信息来源、谵妄药物使用情况、住院和重症监护病房住院时间、90天死亡率。发现11% - 29%的患者存在谵妄，图表回顾法确定的发生率最高。被诊断为谵妄的患者90天死亡率更高，符合所有三种方法标准的患者住院和重症监护病房住院时间更长。
老年重症监护病房的谵妄常常报告不足，需要采取策略来改善医护人员的教育和诊断。
