Ko Ryoung-Eun, Kang Danbee, Park Hyejung, Cho Juhee, Suh Gee Young, Chung Chi Ryang
Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.
J Intensive Care. 2022 Feb 14;10(1):7. doi: 10.1186/s40560-022-00598-4.
Delirium in the intensive care unit (ICU) may be a preventable risk factor for cognitive impairment or psychiatric problems. We aimed to evaluate the association between the presence of delirium during hospitalization involving ICU care and post-discharge cognitive impairment or psychiatric problems.
A retrospective cohort study.
A database of nationwide insurance claims data.
All adult patients aged 18 years or older who were admitted to an ICU between January 1, 2008, and May 31, 2015, and had no history of previous cognitive impairment or psychiatric problems were included in the study.
None.
Of 306,011 patients who met the inclusion criteria, the proportion of those who experienced delirium during hospitalization was 55.0% (n = 168,190). The patients with delirium during hospitalization had significantly increased odds for cognitive impairment (adjusted hazard ratio [HR] 1.17; 95% confidence interval [CI] 1.05-1.29) and psychiatric problems (adjusted HR 1.78; 95% CI 1.67-1.90) after discharge compared with patients without delirium. In patients who had delirium, the incidence of cognitive impairment was 210.8 per 1000 person-years. In 19,496 patients who were diagnosed with cognitive impairment, depression (n = 3233, 16.5%), sleep disorder (n = 1791, 9.2%), and anxiety (n = 1683, 8.6%) were commonly co-diagnosed. The most common psychiatric problem was sleep disorder (148.7 per 1000 person-years), followed by depression (133.3 per 1000 person-years).
Among patients received ICU care, those who experienced delirium during hospitalization had an increased risk of developing cognitive impairment or psychiatric problems post-discharge. Many patients showed multiple cognitive impairment and psychiatric problems during the follow-up period. Efforts to decrease these problems should be made to increase the quality of life of these ICU survivors.
重症监护病房（ICU）中的谵妄可能是认知障碍或精神问题的一个可预防的风险因素。我们旨在评估在涉及ICU护理的住院期间出现谵妄与出院后认知障碍或精神问题之间的关联。
一项回顾性队列研究。
一个全国性保险理赔数据的数据库。
纳入2008年1月1日至2015年5月31日期间入住ICU且既往无认知障碍或精神问题病史的所有18岁及以上成年患者。
无。
在符合纳入标准的306,011名患者中，住院期间经历谵妄的患者比例为55.0%（n = 168,190）。与未发生谵妄的患者相比，住院期间发生谵妄的患者出院后出现认知障碍（调整后风险比[HR] 1.17；95%置信区间[CI] 1.05 - 1.29）和精神问题（调整后HR 1.78；95% CI 1.67 - 1.90）的几率显著增加。在发生谵妄的患者中，认知障碍的发病率为每1000人年210.8例。在19,496名被诊断为认知障碍的患者中，常见的共病诊断有抑郁症（n = 3233，16.5%）、睡眠障碍（n = 1791，9.2%）和焦虑症（n = 1683，8.6%）。最常见的精神问题是睡眠障碍（每1000人年148.7例），其次是抑郁症（每1000人年133.3例）。
在接受ICU护理的患者中，住院期间经历谵妄的患者出院后发生认知障碍或精神问题的风险增加。许多患者在随访期间出现多种认知障碍和精神问题。应努力减少这些问题，以提高这些ICU幸存者的生活质量。
