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抑郁和焦虑会增加重症监护病房患者发生谵妄的几率;一项前瞻性观察研究。

Depression and anxiety increase the odds of developing delirium in ICU patients; a prospective observational study.

作者信息

Arbabi Mohammad, Dezhdar Zhaleh, Amini Behnam, Dehnavi Ali Zare, Ghasemi Moein

机构信息

Brain & Spinal Cord Injury Research Centre, Tehran University of Medical Sciences, Tehran, Iran.

Psychosomatic Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Cogn Neuropsychiatry. 2022 Jan;27(1):1-10. doi: 10.1080/13546805.2021.1991295. Epub 2021 Oct 22.

Abstract

BACKGROUND

Delirium is prevalent among hospitalised patients, especially in critically ill patients. Preventing delirium by recognising its modifiable risk factors could improve life quality, decrease mortality and restrain its devastating consequences.

METHOD

We investigated 50 patients who had been hospitalised in the general ICU and monitored them for developing delirium. We employed CAM and CAM-ICU Scales to assess delirium, RASS score to determine the consciousness level, HADS questionnaire for anxiety and depression, and the demographic data questionnaire.

RESULTS

We found that 20% of ICU patients developed delirium and found a meaningful correlation between the incident delirium, older ages, visual impairment, and higher anxiety and depression scores (HADS) of first and second days of hospitalisation. By utilising logistic regression, we found that older ages, visual impairment, higher anxiety and depression scores (HADS) of the first day of hospitalisation were statistically significant to predict the risk model of developing delirium.

CONCLUSION

Depressive and anxiety symptoms were associated with higher odds of transitioning to delirium; so, at the admission time, it may be useful to screen patients for the symptoms of affective disorders, particularly, who are at higher risks for developing delirium.

摘要

背景

谵妄在住院患者中很常见,尤其是在危重症患者中。通过识别可改变的风险因素来预防谵妄可以提高生活质量、降低死亡率并抑制其破坏性后果。

方法

我们调查了50名入住综合重症监护病房(ICU)的患者,并监测他们是否发生谵妄。我们采用意识模糊评估法(CAM)和重症监护病房意识模糊评估法(CAM-ICU)量表评估谵妄,采用 Richmond躁动镇静评分(RASS)来确定意识水平,采用医院焦虑抑郁量表(HADS)问卷评估焦虑和抑郁情况,并使用人口统计学数据问卷。

结果

我们发现20%的ICU患者发生了谵妄,并发现住院第一天和第二天发生谵妄、年龄较大、视力障碍以及较高的焦虑和抑郁评分(HADS)之间存在显著相关性。通过逻辑回归分析,我们发现年龄较大、视力障碍、住院第一天较高的焦虑和抑郁评分(HADS)对预测发生谵妄的风险模型具有统计学意义。

结论

抑郁和焦虑症状与转变为谵妄的较高几率相关;因此,在入院时,对患者进行情感障碍症状筛查可能是有用的,特别是对于那些发生谵妄风险较高的患者。

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