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谵妄研究活动是否会影响常规谵妄识别?一项前瞻性队列研究。

Can delirium research activity impact on routine delirium recognition? A prospective cohort study.

机构信息

Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

出版信息

BMJ Open. 2018 Oct 31;8(10):e023386. doi: 10.1136/bmjopen-2018-023386.

Abstract

OBJECTIVE

To assess if ongoing delirium research activity within an acute admissions unit impacts on prevalent delirium recognition.

DESIGN

Prospective cohort study.

SETTING

Single-site tertiary university teaching hospital.

PARTICIPANTS

125 patients with delirium, as diagnosed by an expert using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition reference criteria, were recruited to a prospective cohort study investigating use of informant tools to detect unrecognised dementia. This study evaluated recognition of delirium and documentation of delirium by medical staff.

INTERVENTIONS

The main study followed an observational design; the intervention discussed was the implementation of this study itself.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was recognition of delirium by the admitting medical team prior to study diagnosis. Secondary outcomes included recording of or description of delirium in discharge summaries, and factors which may be associated with unrecognised delirium.

RESULTS

Delirium recognition improved between the first half (48%) and second half (71%) of recruitment (p=0.01). There was no difference in recording of delirium or description of delirium in the text of discharge summaries.

CONCLUSION

Delirium research activity can improve recognition of delirium. This has the potential to improve patient outcomes.

摘要

目的

评估急性入院病房中持续进行的谵妄研究活动是否会影响普遍的谵妄识别。

设计

前瞻性队列研究。

地点

单站点三级大学教学医院。

参与者

125 名患有谵妄的患者,通过使用《精神障碍诊断与统计手册》第四版参考标准的专家诊断为患有谵妄,被招募到一项前瞻性队列研究中,该研究调查了使用信息工具来检测未被识别的痴呆症。本研究评估了医务人员对谵妄的识别和对谵妄的记录。

干预措施

主要研究采用观察性设计;讨论的干预措施是实施这项研究本身。

主要和次要结局测量

主要结局是在研究诊断之前,入院医疗团队对谵妄的识别。次要结局包括在出院总结中记录或描述谵妄,以及可能与未被识别的谵妄相关的因素。

结果

在招募的前半部分(48%)和后半部分(71%)之间,谵妄的识别有所改善(p=0.01)。出院总结的文本中,对谵妄的记录或描述没有差异。

结论

谵妄研究活动可以提高对谵妄的识别。这有可能改善患者的结局。

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