早期家庭重新启动精神药物治疗对重症监护病房谵妄替代指标的影响。
Impact of early home psychotropic medication reinitiation on surrogate measures of intensive care unit delirium.
作者信息
Li Matthew, Chang Mei H, Miranda-Valdes Yeismel, Vest Kirsten, Kish Troy D
出版信息
Ment Health Clin. 2019 Jul 1;9(4):263-268. doi: 10.9740/mhc.2019.07.263. eCollection 2019 Jul.
INTRODUCTION
Intensive care unit (ICU) delirium is a major contributing factor to increased mortality, length of stay, and cost of care. Psychotropic medications may often require extensive tapering to prevent withdrawal symptoms; during ICU admission, home psychotropics are frequently held which may precipitate acute drug withdrawal and subsequent delirium.
METHODS
This is a single-center, observational, retrospective chart review. The primary endpoint was the total number of new-start antipsychotics used to treat ICU delirium. Secondary endpoints included use of restraints, ICU length of stay, and hospital length of stay.
RESULTS
A total of 2334 charts were reviewed for inclusion; 55 patients were categorized into each group. There was no statistically significant difference in the requirement for new-start antipsychotics ( = 1.0), restraint use ( = .057), or ICU length of stay ( = .71). There was a statistically significant decrease in hospital length of stay ( = .048).
DISCUSSION
Early reinitiation was associated with a decrease in hospital length of stay but was not associated with a decrease in the number of new-start antipsychotics, use of restraints, or ICU length of stay.
引言
重症监护病房（ICU）谵妄是导致死亡率增加、住院时间延长和护理成本上升的主要因素。精神药物通常需要逐步减量以预防戒断症状；在入住ICU期间，经常停用家庭使用的精神药物，这可能会引发急性药物戒断及随后的谵妄。
方法
这是一项单中心、观察性、回顾性病历审查。主要终点是用于治疗ICU谵妄的新启用抗精神病药物的总数。次要终点包括约束措施的使用、ICU住院时间和住院时间。
结果
共审查了2334份病历以纳入研究；每组有55名患者。在新启用抗精神病药物的需求（=1.0）、约束措施的使用（=0.057）或ICU住院时间（=0.71）方面，无统计学显著差异。住院时间有统计学显著缩短（=0.048）。
讨论
早期重新启用与住院时间缩短相关，但与新启用抗精神病药物的数量减少、约束措施的使用或ICU住院时间缩短无关。
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