Grupo de Investigación en Psiquiatría de Enlace (GIPE), Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Gen Hosp Psychiatry. 2020 Nov-Dec;67:107-114. doi: 10.1016/j.genhosppsych.2020.10.003. Epub 2020 Oct 13.
To evaluate whether the Delirium Diagnostic Tool-Provisional (DDT-Pro), a 0-9 point scale with three items each representing symptoms from delirium's three core domains, differentiates subsyndromal delirium (SSD) from delirium and no delirium.
We applied cluster analyses of DDT-Pro scores from 200 consecutive inpatients using three reference standards for delirium diagnosis to determine DDT-Pro cutoff values for delirium, SSD and no delirium groups. Clinical validators and DDT-Pro item scores were compared among groups.
DDT-Pro SSD range was 6-7 (n = 54), with no delirium having higher scores (n = 98) and delirium lower (n = 48). Dementia prevalence in the SSD group (40.7%) was intermediate between no delirium (20.4%) and delirium (66.7%). SSD and delirium groups were more affected than no delirium regarding medical comorbidities, hospital stay (no delirium <1 week, SSD and delirium >1 week) and mortality (SSD = 7.4%, delirium = 18.8%, no delirium = 1%). Values for motor subtypes, frontal lobe signs, and DRS-R98 in the SSD group were intermediate between no delirium and delirium, as well as for the DDT-Pro items (all p < 0.05).
All DDT-Pro items, which represent the three delirium core domains, are important for SSD diagnosis. Patients scoring in the SSD 6-7 range have significant clinical and prognostic features and deserve clinical attention.
评估 Delirium Diagnostic Tool-Provisional(DDT-Pro),一个 0-9 分制的量表,每个项目代表谵妄的三个核心领域中的一个症状,是否能区分亚综合征谵妄(SSD)与谵妄和非谵妄。
我们对 200 例连续住院患者的 DDT-Pro 评分进行聚类分析,使用三种谵妄诊断参考标准来确定 DDT-Pro 对谵妄、SSD 和非谵妄组的截断值。比较各组的临床验证者和 DDT-Pro 项目评分。
DDT-Pro SSD 范围为 6-7(n=54),非谵妄组的得分较高(n=98),谵妄组的得分较低(n=48)。SSD 组的痴呆患病率(40.7%)介于非谵妄组(20.4%)和谵妄组(66.7%)之间。SSD 和谵妄组与非谵妄组相比,在合并症、住院时间(非谵妄组<1 周,SSD 组和谵妄组>1 周)和死亡率(SSD=7.4%,谵妄=18.8%,非谵妄=1%)方面受影响更大。SSD 组的运动亚型、额叶体征和 DRS-R98 值在非谵妄和谵妄之间处于中间水平,DDT-Pro 项目也是如此(均 p<0.05)。
所有代表谵妄三个核心领域的 DDT-Pro 项目对 SSD 诊断都很重要。评分在 SSD 6-7 范围内的患者具有显著的临床和预后特征,值得临床关注。