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髋关节急诊手术后的谵妄——常见且严重,但很少有人对此表示同意。

Delirium after emergency hip surgery - common and serious, but rarely consented for.

作者信息

Koizia Louis J, Wilson Faye, Reilly Peter, Fertleman Michael B

机构信息

Geriatric Medicine, Imperial College NHS Trust, London W2 1NY, United Kingdom.

Geriatric Medicine, City Hospitals Sunderland, Sunderland SR4 7TP, United Kingdom.

出版信息

World J Orthop. 2019 Jun 18;10(6):228-234. doi: 10.5312/wjo.v10.i6.228.

Abstract

A quarter of patients admitted with a proximal femoral fracture suffer from an acute episode of delirium during their hospital stay. Yet it is often unrecognised, poorly managed, and rarely discussed by doctors. Delirium is important not only to the affected individuals and their families, but also socioeconomically to the broader community. Delirium increases mortality and morbidity, leads to lasting cognitive and functional decline, and increases both length of stay and dependence on discharge. Delirium should be routinely and openly discussed by all members of the clinical team, including surgeons when gaining consent. Failing to do so may expose surgeons to claims of negligence. Here we present a concise review of the literature and discuss the epidemiology, causative factors, potential consequences and preventative strategies in the perioperative period.

摘要

四分之一因股骨近端骨折入院的患者在住院期间会经历急性谵妄发作。然而,这种情况常常未被识别、管理不善,医生也很少对此进行讨论。谵妄不仅对受影响的个体及其家庭很重要,从社会经济角度来看,对更广泛的社区也很重要。谵妄会增加死亡率和发病率,导致持久的认知和功能衰退,并增加住院时间和出院后的依赖性。临床团队的所有成员,包括外科医生在获得患者同意时,都应该常规且公开地讨论谵妄问题。不这样做可能会使外科医生面临过失索赔。在此,我们对文献进行简要综述,并讨论围手术期的流行病学、致病因素、潜在后果和预防策略。

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