Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
Department of Geriatric Nursing, Toho University Faculty of Nursing, Tokyo, Japan.
Geriatr Gerontol Int. 2022 Oct;22(10):883-888. doi: 10.1111/ggi.14477. Epub 2022 Sep 7.
Although older people are at an increased risk of developing delirium during hospitalization, no definitive screening tools exist to predict the condition. This study aimed to examine the effectiveness of the noise pareidolia test (NPT) as a tool for predicting the onset of post-hospitalization delirium in older adults.
Hospitalized patients who were cared for by a multidisciplinary geriatric care team owing to behavioral symptoms, difficulties in communication, and a history of dementia or delirium were analyzed. The NPT was performed on patients who could complete a Mini-Mental State Examination within 3 days of admission. Demographic and clinical data were recorded on the same day as the NPT or within 3 days of admission. Delirium was assessed using the observation-based Delirium Screening Tool (DST).
Of 96 patients, 59 were in the DST-negative group and 37 in the DST-positive group. Benzodiazepine agonist use, serum potassium levels, and the number of images in which pareidolia was noted (i.e., the NPT score) significantly differed between groups. Logistic regression analysis identified benzodiazepine agonist use (odds ratio, 2.897; P = 0.032), serum potassium levels (odds ratio, 0.427; P = 0.041) and NPT scores (odds ratio, 1.253; P = 0.017) as significant predictors of DST results. The receiver operating characteristic curve analysis showed an NPT score of 1 as the appropriate cutoff value.
A positive NPT score was identified as an independent predictor of delirium in older patients admitted to an acute care hospital with cognitive dysfunction. Geriatr Gerontol Int 2022; 22: 883-888.
尽管老年人在住院期间发生谵妄的风险增加，但目前尚无明确的筛查工具来预测这种情况。本研究旨在探讨噪声幻觉测试（NPT）作为预测老年人住院后谵妄发生的一种工具的有效性。
对因行为症状、沟通困难以及痴呆或谵妄病史而由多学科老年护理团队护理的住院患者进行分析。对在入院后 3 天内能够完成简易精神状态检查的患者进行 NPT。在进行 NPT 的当天或入院后 3 天内记录患者的人口统计学和临床数据。使用基于观察的谵妄筛查工具（DST）评估谵妄。
在 96 名患者中，59 名患者为 DST 阴性组，37 名患者为 DST 阳性组。苯二氮䓬类激动剂的使用、血清钾水平以及出现幻觉的图像数量（即 NPT 评分）在两组之间存在显著差异。Logistic 回归分析确定苯二氮䓬类激动剂的使用（比值比，2.897；P=0.032）、血清钾水平（比值比，0.427；P=0.041）和 NPT 评分（比值比，1.253；P=0.017）是 DST 结果的显著预测因素。受试者工作特征曲线分析显示 NPT 得分为 1 是急性护理医院认知功能障碍老年患者发生谵妄的合适截断值。
阳性 NPT 评分被确定为预测急性护理医院认知功能障碍老年患者发生谵妄的独立预测因子。
