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重症监护病房患者术后谵妄的发生率及危险因素:PREDICt研究的研究方案

Incidence and risk factors of PostopeRativE delirium in intensive care unit patients: A study protocol for the PREDICt study.

作者信息

Cai Shining, Lv Minzhi, Latour Jos M, Lin Ying, Pan Wenyan, Zheng Jili, Cheng Lihong, Li Jingjing, Zhang Yuxia

机构信息

Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

J Adv Nurs. 2019 Nov;75(11):3068-3077. doi: 10.1111/jan.14097. Epub 2019 Aug 5.

Abstract

AIM

The aims of this study are: (a) to determine the incidence of postoperative delirium (POD) among surgical intensive care unit (ICU) patients in China and identify risk factors, especially, which are modifiable and have value for developing a prediction model; (b) to develop and validate a prediction model of delirium to recognize high-risk patients in surgical ICUs; (c) to investigate the short- and long-term outcomes of delirious patients and identify the predictors of patient outcomes.

DESIGN

A single-centre prospective cohort study.

METHODS

Patients will be enrolled from three surgical ICUs in a tertiary teaching hospital. Delirium assessment and perioperative data will be collected throughout the hospitalization. Delirious patients will be followed up for 2 years. The study was approved by the ethics committee in May 2018 and was funded by the clinical research grant from Zhongshan hospital, Fudan University, Shanghai.

DISCUSSION

Developing POD can be a burden to patients both for the short- and long-term period. Due to the lack of effective treatments for POD, prevention remains the best strategy. This study will provide an effective tool for early screening of high-risk patients of POD and provide a better understanding of the aetiology and outcome of delirium.

IMPACT

In clinical practice, a prediction model will offer an effective tool for ICU nurses to assess high-risk patients, which can support them to implement preventive strategies at the early stages to targeted patients. The follow-up results will help us better understand the impact of delirium on patients' long-term outcome.

摘要

目的

本研究的目的如下:(a)确定中国外科重症监护病房(ICU)患者术后谵妄(POD)的发生率,并识别风险因素,尤其是可改变且对建立预测模型有价值的因素;(b)建立并验证谵妄预测模型,以识别外科ICU中的高危患者;(c)调查谵妄患者的短期和长期结局,并识别患者结局的预测因素。

设计

单中心前瞻性队列研究。

方法

将从一家三级教学医院的三个外科ICU招募患者。在整个住院期间收集谵妄评估和围手术期数据。对谵妄患者进行为期2年的随访。本研究于2018年5月获得伦理委员会批准,并由上海复旦大学附属中山医院的临床研究基金资助。

讨论

发生POD无论对患者的短期还是长期而言都可能是一种负担。由于缺乏针对POD的有效治疗方法,预防仍然是最佳策略。本研究将为早期筛查POD高危患者提供有效工具,并有助于更好地了解谵妄的病因和结局。

影响

在临床实践中,预测模型将为ICU护士评估高危患者提供有效工具,有助于他们在早期对目标患者实施预防策略。随访结果将帮助我们更好地了解谵妄对患者长期结局的影响。

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