Thomas R I, Cameron D J, Fahs M C
Department of Community Medicine, Mount Sinai School of Medicine, New York.
Arch Gen Psychiatry. 1988 Oct;45(10):937-40. doi: 10.1001/archpsyc.1988.01800340065009.
Using explicit criteria, delirium was diagnosed in 15% of a cohort of 133 hospitalized patients. Following each patient's discharge or death, the length of stay was compared with the diagnosis related group-predicted length of hospitalization. An analysis of stay variations disclosed that delirious patients exceeded their predicted stay by an average of 13 days, while nondelirious patients exceeded theirs by 3.3 days. The mean (+/- SD) length of hospitalization for patients with delirium was significantly longer than for their nondelirious counterparts (21.6 +/- 23.7 days vs 10.6 +/- 10.1 days, respectively). Hospitals treating high proportions of patients with delirium as a comorbidity to a principal somatic diagnosis should institute measures for the early detection of and appropriate intervention in patients with this condition. These steps may help reduce prolonged hospitalizations and minimize financial risk under the current diagnosis related group reimbursement system.
采用明确的标准，在133名住院患者队列中，15%的患者被诊断为谵妄。在每位患者出院或死亡后，将住院时间与诊断相关组预测的住院时间进行比较。对住院时间差异的分析显示，谵妄患者的实际住院时间比预测住院时间平均多出13天，而非谵妄患者则多出3.3天。谵妄患者的平均（±标准差）住院时间显著长于非谵妄患者（分别为21.6±23.7天和10.6±10.1天）。将高比例谵妄患者作为主要躯体诊断的合并症进行治疗的医院，应制定措施，以便对患有这种病症的患者进行早期检测和适当干预。在当前的诊断相关组报销系统下，这些措施可能有助于减少住院时间延长，并将财务风险降至最低。
