Rogers M P, Liang M H, Daltroy L H, Eaton H, Peteet J, Wright E, Albert M
Psychiatry Division, Brigham and Women's Hospital, Boston, MA 02115.
Int J Psychiatry Med. 1989;19(2):109-21. doi: 10.2190/2q3v-hyt4-nn49-bpr4.
Forty-six orthopedic patients were studied to determine the incidence, natural history, and risk factors associated with post-operative delirium. Pre-operatively, patients were given a neuropsychological screening evaluation, the Mood Adjective Checklist (MACL), the Zung Depression Scale, the Anxiety Inventory Scale, and the Health Assessment Questionnaire (HAQ). A psychiatrist interviewed each patient on post-op day four for evidence of delirium as defined by DSM III criteria. Of the patients studied, thirteen (26%) were possibly or definitely delirious following surgery. Treatment with propranolol, scopolamine, or flurazepam (Dalmane) conferred a relative risk for delirium of 11.7 (p = 0.0028). Delirium was associated with increased post-operative complications (p = 0.01), poorer post-operative mood (p = 0.06), and an increase of about 1.5 days in length of stay (not significant). Delirious patients were significantly less likely than matched controls to improve in function at six months compared with a pre-operative baseline HAQ (t = 6.43, p less than 0.001).
对46名骨科患者进行了研究，以确定术后谵妄的发生率、自然病程及相关危险因素。术前，对患者进行神经心理学筛查评估，包括情绪形容词检查表（MACL）、zung抑郁量表、焦虑量表和健康评估问卷（HAQ）。术后第4天，由精神科医生对每位患者进行访谈，以确定是否有符合DSM III标准的谵妄证据。在所研究的患者中，13名（26%）在术后可能或肯定发生了谵妄。使用普萘洛尔、东莨菪碱或氟西泮（氟安定）治疗使谵妄的相对风险为11.7（p = 0.0028）。谵妄与术后并发症增加（p = 0.01）、术后情绪较差（p = 0.06）以及住院时间延长约1.5天（无统计学意义）相关。与术前基线HAQ相比，谵妄患者在6个月时功能改善的可能性明显低于匹配的对照组（t = 6.43，p < 0.001）。
