Skretteberg Wenche H, Holmefoss Ingunn, Krogseth Maria
Modumheimen Nursing Home, Municipality of Modum, Modum, Norway; University of South-Eastern Norway, Drammen, Norway.
Department of Long-term Care, Municipality of Drammen, Drammen, Norway.
J Am Med Dir Assoc. 2022 Jan;23(1):146-149. doi: 10.1016/j.jamda.2021.10.006. Epub 2021 Nov 10.
Assess the frequency of delirium during any acute event, its risk factors, and the duration of delirium in nursing home patients.
Prospective 2-month follow-up study.
145 nursing home patients living in 3 Norwegian nursing homes.
At baseline, known risk factors for delirium were obtained from medical records. During any acute events where the nurses decided that a physician had to be alerted, the Confusion Assessment Method was used to identify delirium on days 1, 2, 4, and 6 and thereafter weekly if delirium was present on day 6. The precipitating cause of delirium was registered based on diagnostics performed and treatment given.
One or more acute events occurred in 57 patients, and 34 (60%) of these patients developed delirium. In 91% of the patients with delirium, the delirium was present when the physician was alerted about the acute change. Delirium lasted for more than 1 week in 15 of the 34 patients. In 18 of the 34 patients with delirium, an infection was its precipitating factor. Regular use of benzodiazepines and a diagnosis of vascular dementia were significantly associated with delirium in the logistic regression model adjusted for age, number of drugs, and comorbidity [adjusted odds ratio (95% confidence interval) 3.75 (1.44-9.74) and 5.59 (1.53-20.43), respectively].
Acute events and illness were common in nursing home patients, and in our study, 60% had delirium associated with the event. In 9 of 10 patients, the delirium was present when the physician was alerted about the acute change, and infection was the most frequent cause of the delirium. Regular use of benzodiazepines and a diagnosis of vascular dementia were independent predisposing factors for delirium.
评估疗养院患者在任何急性事件期间谵妄的发生率、危险因素及谵妄持续时间。
前瞻性2个月随访研究。
挪威3家疗养院的145名疗养院患者。
在基线时，从病历中获取已知的谵妄危险因素。在护士决定需通知医生的任何急性事件期间，采用谵妄评估方法在第1、2、4和6天识别谵妄，若第6天存在谵妄，则此后每周进行评估。根据所做诊断和给予的治疗记录谵妄的诱发原因。
57名患者发生了一次或多次急性事件，其中34名（60%）患者出现谵妄。在91%的谵妄患者中，医生接到急性变化通知时患者已出现谵妄。34名患者中有15名谵妄持续超过1周。34名谵妄患者中有18名，感染是其诱发因素。在调整年龄、药物数量和合并症的逻辑回归模型中，经常使用苯二氮䓬类药物和血管性痴呆诊断与谵妄显著相关[调整比值比（95%置信区间）分别为3.75（1.44 - 9.74）和5.59（1.53 - 20.43）]。
急性事件和疾病在疗养院患者中很常见，在我们的研究中，60%的患者谵妄与该事件相关。在十分之九的患者中，医生接到急性变化通知时患者已出现谵妄，感染是谵妄最常见的原因。经常使用苯二氮䓬类药物和血管性痴呆诊断是谵妄的独立诱发因素。
