Al Huraizi Aisha Ramadhan, Al-Maqbali Juhaina Salim, Al Farsi Rajaa Saleh, Al Zeedy Khalfan, Al-Saadi Taif, Al-Hamadani Noof, Al Alawi Abdullah M
Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman.
Department of Pharmacy, Sultan Qaboos University Hospital, Muscat 123, Oman.
J Clin Med. 2023 Aug 17;12(16):5346. doi: 10.3390/jcm12165346.
Delirium is highly prevalent among elderly hospitalized patients in various healthcare settings. This study aimed to assess the impact of delirium on short- and long-term health outcomes.
A prospective cohort included medically ill patients (≥65 years) admitted to a tertiary healthcare facility. Delirium was screened using the 3-Minute Diagnostic confusion assessment method (3D-CAM).
During hospitalization, 53.8% ( = 153/284) had delirium. Patients with delirium had a longer length of hospital stay (LOS) (7 vs. 5 days; < 0.01) compared to patients without delirium. Delirium caused a higher frequency of high-dependency unit (HDU) or intensive care unit (ICU) admission ( < 0.01) and an increased incidence of hospital-acquired complications, including infections ( = 0.03), pressure injuries ( = 0.01), and upper gastrointestinal bleeding ( < 0.01). Inpatient all-cause mortality was higher in patients with delirium than those without delirium (16.3% vs. 1.5%; < 0.01). Patients with delirium had higher rates of 90-day all-cause mortality (25.4% vs. 8.4%; < 0.01) and 1-year all-cause mortality (35.9% vs. 16%; < 0.01) compared to patients without delirium. Patients with delirium exhibited shorter survival periods at 90 days and 1 year compared to patients without delirium with a hazard ratio (HR) = 3.41, 95% CI: 1.75-6.66, < 0.01 and HR = 2.64, 95% CI: 1.59-4.37, < 0.01, respectively.
Delirium is associated with serious short-term and long-term clinical consequences. Early recognition, prevention, and targeted interventions addressing reversible risk factors are crucial. Further research is warranted to explore effective strategies for delirium management in general medical wards.
谵妄在各类医疗环境中的老年住院患者中极为常见。本研究旨在评估谵妄对短期和长期健康结局的影响。
一项前瞻性队列研究纳入了入住三级医疗机构的内科疾病患者（≥65岁）。使用3分钟诊断性意识模糊评估法（3D - CAM）筛查谵妄。
住院期间，53.8%（=153/284）的患者发生谵妄。与未发生谵妄的患者相比，发生谵妄的患者住院时间更长（7天对5天；<0.01）。谵妄导致更高频率的高依赖病房（HDU）或重症监护病房（ICU）入住（<0.01），且医院获得性并发症的发生率增加，包括感染（=0.03）、压疮（=0.01）和上消化道出血（<0.01）。发生谵妄的患者住院全因死亡率高于未发生谵妄的患者（16.3%对1.5%；<0.01）。与未发生谵妄的患者相比，发生谵妄的患者90天全因死亡率（25.4%对8.4%；<0.01）和1年全因死亡率（35.9%对16%；<0.01）更高。与未发生谵妄的患者相比，发生谵妄的患者在90天和1年时的生存期更短，危险比（HR）分别为3.41，95%可信区间：1.75 - 6.66，<0.01和HR = 2.64，95%可信区间：1.59 - 4.37，<0.01。
谵妄与严重的短期和长期临床后果相关。早期识别、预防以及针对可逆危险因素的靶向干预至关重要。有必要进一步开展研究以探索普通内科病房中谵妄管理的有效策略。
