Department of Gastroenterological Surgery, St. Luke's International Hospital, Tokyo, Japan.
Center for Clinical Epidemiology, St. Luke's International University, Tokyo, Japan.
Ann Surg. 2018 May;267(5):874-877. doi: 10.1097/SLA.0000000000002347.
The primary purpose of this study was to assess risk factors for delirium in patients staying in a surgical ward for more than 5 days. The secondary purpose was to assess outcomes in patients with delirium.
Delirium is a syndrome characterized by acute fluctuations in mental status. Patients with delirium are at increased risk of adverse inpatient events, higher mortality and morbidity rates, prolonged hospital stays, and increased health care costs.
Participants in this study were 2168 patients who had been admitted to the surgical ward of St. Luke's International Hospital for 5 days or more between January 2011 and December 2014. Data on these patients were collected retrospectively from hospital medical records. Firstly, univariate and multivariate analyses were conducted to identify risk factors for delirium. Secondly, morbidity and mortality associated with delirium were analyzed.
Delirium occurred in 205 of 2168 patients (9.5%). Age, physical restraint, past history of a cerebrovascular disorder, malignancy, intensive care unit stay, pain, and high blood urea nitrogen value were significant risk factors for delirium in the multivariate analysis. Among these, age was the strongest factor, with an odds ratio for delirium of 12.953 in patients 75 years of age or older. The length of hospital stays and the mortality rates were higher in patients with delirium.
Results showed that age, and also physical restraint, past history of cerebrovascular disorder, malignancy, intensive care unit stay, pain, and high serum blood urea nitrogen were important factors associated with delirium in patients hospitalized for more than 5 days in a surgical ward.
本研究的主要目的是评估在外科病房住院超过 5 天的患者发生谵妄的危险因素。次要目的是评估谵妄患者的结局。
谵妄是一种以精神状态急性波动为特征的综合征。谵妄患者发生不良住院事件、更高的死亡率和发病率、住院时间延长以及医疗保健费用增加的风险增加。
本研究的参与者是 2011 年 1 月至 2014 年 12 月期间在圣卢克国际医院外科病房住院 5 天或以上的 2168 名患者。这些患者的数据是从医院病历中回顾性收集的。首先,进行单变量和多变量分析以确定谵妄的危险因素。其次,分析与谵妄相关的发病率和死亡率。
在 2168 名患者中,有 205 名(9.5%)发生了谵妄。年龄、身体约束、脑血管疾病史、恶性肿瘤、重症监护病房停留、疼痛和高血尿素氮值是多变量分析中谵妄的显著危险因素。在这些因素中,年龄是最强的因素,75 岁或以上患者发生谵妄的比值比为 12.953。谵妄患者的住院时间和死亡率较高。
结果表明,年龄以及身体约束、脑血管疾病史、恶性肿瘤、重症监护病房停留、疼痛和高血清血尿素氮是在外科病房住院超过 5 天的患者发生谵妄的重要因素。