Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta Health Services, Calgary, AB, Canada; O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada.
J Crit Care. 2020 Apr;56:257-264. doi: 10.1016/j.jcrc.2020.01.017. Epub 2020 Jan 15.
Use systematic review methodology to summarize risk factors and outcomes for each delirium subtype (hypoactive, hyperactive and mixed) in an adult ICU population.
We searched the MEDLINE, Embase, CINAHL, SCOPUS, Web of Science and PsycINFO databases from database inception until August 13, 2018, with no restrictions.
Of 9635 abstracts, 20 studies were included. Older age was not associated with any delirium subtype in 4/7 (57%) studies. Sex was not associated with any delirium subtype in 4/4 (100%) studies. Mortality was consistently associated with hypoactive delirium in 4/7 (57%) studies. The evidence supporting the association of APACHE-II score, mechanical ventilation, length of stay, duration of delirium and removal of tubes were inconsistent across studies.
Although included studies reported on many subtype-specific risk factors and outcomes, heterogeneity in reporting and methodological quality limited the generalizability of the results and the evidence for many subtype-specific risk factors or outcomes is inconsistent across studies. Standardized methodology and the creation of a universal template for collecting data in ICU delirium studies are essential moving forward; helping to identify subtype-specific risk factors or outcomes and strengthen the association of potential risk factors or outcomes.
采用系统综述方法总结成人 ICU 人群中每种谵妄亚型（低活动型、高活动型和混合性）的危险因素和结局。
我们从数据库建立之初到 2018 年 8 月 13 日，在 MEDLINE、Embase、CINAHL、SCOPUS、Web of Science 和 PsycINFO 数据库中进行了无限制的检索。
在 9635 篇摘要中，有 20 项研究被纳入。4/7（57%）项研究表明，年龄与任何一种谵妄亚型均无关。4/4（100%）项研究表明，性别与任何一种谵妄亚型均无关。4/7（57%）项研究表明，死亡率与低活动型谵妄始终相关。支持急性生理与慢性健康状况评分 II（APACHE-II）评分、机械通气、住院时间、谵妄持续时间和导管拔除与谵妄亚型之间关联的证据在不同研究中不一致。
尽管纳入的研究报告了许多亚型特异性的危险因素和结局，但报告的异质性和方法学质量限制了结果的普遍性，许多亚型特异性危险因素或结局的证据在不同研究中不一致。标准化方法和创建 ICU 谵妄研究中数据收集的通用模板对于未来的研究至关重要；有助于确定亚型特异性危险因素或结局，并加强潜在危险因素或结局的相关性。
