Department of Neurology, Department of Emergency Medicine, Malatya Training and Research Hospital, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Jun;26(12):4440-4448. doi: 10.26355/eurrev_202206_29083.
Delirium is an acute disorder in which attention, perception, memory, thought, mood, psychomotor activity and sleep-wake cycles change rapidly. Delirium is also a common clinical syndrome in patients hospitalized in intensive care units due to COVID-19 pneumonia. We reviewed clinical features and predisposing factors of delirium according to psychomotor subtype in patients hospitalized in the intensive care units due to COVID-19 pneumonia.
64 patients who were hospitalized in the intensive care units due to COVID-19 pneumonia were included. Delirium status and psychomotor subtype were determined by applying the Confusion Assessment Method for the Intensive Care Unit scale to the patients daily. The gender, age, comorbidity, treatments, intubation, and mortality rates of the patients were recorded. Multivariate analyses were performed by examining predisposing factors, arterial blood gases, hemograms, biochemistry, and brain magnetic resonance imaging.
There were 64 patients in delirium clinic, 65.6% (n=42) of them were male. Hypokinetic delirium was more common in 60.9% (n=39). 79.4% of the patients who received ventilator support were male (p=0.013).When mortality was analyzed in this group, hypoactive delirium was found to be significantly higher (p=0.035). In addition, leukocyte levels were higher in patients with hypokinetic delirium (p=0.029). Ferritin and fibrinogen levels were higher in patients with hyperkinetic delirium (p=0.039, p=0.008, respectively).
The presence of additional diseases such as advanced age, male gender, hypertension, coronary artery disease, dementia, and hypoxia were factors that increased the frequency of delirium. In addition, the mortality rate was higher in patients with hypokinetic delirium.
谵妄是一种注意力、知觉、记忆、思维、情绪、精神运动活动和睡眠-觉醒周期迅速变化的急性障碍。谵妄也是因 COVID-19 肺炎住院于重症监护病房的患者常见的临床综合征。我们根据因 COVID-19 肺炎住院于重症监护病房的患者的精神运动亚型回顾了谵妄的临床特征和易患因素。
共纳入 64 例因 COVID-19 肺炎住院于重症监护病房的患者。通过对患者每日应用重症监护病房谵妄评估法评估谵妄状态和精神运动亚型。记录患者的性别、年龄、合并症、治疗、插管和死亡率。通过检查易患因素、动脉血气、血常规、生化和脑磁共振成像进行多变量分析。
有 64 例患者出现谵妄，其中 65.6%（n=42）为男性。运动减少性谵妄更为常见（60.9%，n=39）。接受呼吸机支持的患者中 79.4%为男性（p=0.013）。在对该组进行死亡率分析时，发现运动减少性谵妄显著更高（p=0.035）。此外，运动减少性谵妄患者的白细胞水平更高（p=0.029）。在运动增多性谵妄患者中，铁蛋白和纤维蛋白原水平更高（p=0.039，p=0.008）。
合并其他疾病如高龄、男性、高血压、冠心病、痴呆和缺氧等是增加谵妄发生频率的因素。此外，运动减少性谵妄患者的死亡率更高。
