Arora Rakesh C, Djaiani George, Rudolph James L
Department of Surgery, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada.
Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Can J Cardiol. 2017 Jan;33(1):80-87. doi: 10.1016/j.cjca.2016.08.020. Epub 2016 Oct 5.
Delirium is an acute change in cognitive functioning, characterized by inattention and associated with alterations in awareness and fluctuation in arousal, disorganized thinking, or altered level that preferentially affects older adult patients. In the acutely ill cardiac patient, the incidence of delirium has been reported as high as 73%, depending on the type and sensitivity of delirium assessment. Cardiac patients with delirium experience higher rates of in-hospital and longer-term mortality and are at risk for progressive cognitive impairment, loss of functional independence, and increased hospitalization costs. As such, delirium represents an undesirable outcome in cardiac patients. Care improvements such as identifying risk of delirium at time of admission or in the preoperative setting; training cardiologist, surgeons, anaesthesiologists and nurses to screen for delirium; implementing delirium prevention programs; and developing standardized delirium treatment protocols might reduce the incidence of delirium and its associated morbidity.
谵妄是认知功能的急性改变，其特征为注意力不集中，并伴有意识改变、觉醒波动、思维紊乱或意识水平改变，老年患者更易受到影响。在急性病心脏病患者中，谵妄的发生率据报道高达73%，这取决于谵妄评估的类型和敏感性。患有谵妄的心脏病患者住院期间和长期死亡率更高，并有发生进行性认知障碍、失去功能独立性和住院费用增加的风险。因此，谵妄是心脏病患者不良结局的表现。诸如在入院时或术前确定谵妄风险；培训心脏病专家、外科医生、麻醉师和护士进行谵妄筛查；实施谵妄预防计划；以及制定标准化的谵妄治疗方案等护理改进措施，可能会降低谵妄的发生率及其相关发病率。
