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老年患者的谵妄。

Delirium in geriatric patients.

机构信息

Department of Geriatric Medicine, Salzburg University Hospital-Campus Christian-Doppler-Klinik, and Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria.

Specialist in Internal and Geriatric Medicine, Vienna, Austria.

出版信息

Wien Med Wochenschr. 2022 Apr;172(5-6):114-121. doi: 10.1007/s10354-021-00904-z. Epub 2022 Jan 10.

Abstract

Delirium is the most common acute disorder of cognitive function in older patients. Delirium is life threatening, often under-recognized, serious, and costly. The causes are multifactorial, with old age and neurocognitive disorders as the main risk factors. Etiologies are various and multifactorial, and often related to acute medical illness, adverse drug reactions, or medical complications. To date, diagnosis is clinically based, depending on the presence or absence of certain features. In view of the multifactorial etiology, multicomponent approaches seem most promising for facing patients' needs. Pharmacological intervention, neither for prevention nor for treatment, has been proven effective unanimously. This article reviews the current clinical practice for delirium in geriatric patients, including etiology, pathophysiology, diagnosis, prognosis, treatment, prevention, and outcomes.

摘要

谵妄是老年患者最常见的急性认知功能障碍。谵妄具有生命威胁性,往往未被充分识别,且病情严重,医疗费用高昂。其病因是多因素的,老年和神经认知障碍是主要的危险因素。病因多种多样,且常常与急性躯体疾病、药物不良反应或医疗并发症有关。迄今为止,其诊断主要基于某些特征的存在与否,而采用临床方法。鉴于其病因的多因素性,多组分方法似乎最有希望满足患者的需求。在预防或治疗方面,药物干预均未被一致证明有效。本文综述了老年患者谵妄的当前临床实践,包括病因、病理生理学、诊断、预后、治疗、预防和结局。

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