Frongillo Doriana, Barisone Michela, Gilardi Rossella, Usmiani Tullio, Falsini Giovanni
U.O.C. Cardiologia, Ospedale San Sebastiano Martire, ASL Roma 6, Frascati (RM).
Centro Controllo Direzionale, Azienda Sociosanitaria Ligure ASL2, Savona.
G Ital Cardiol (Rome). 2024 Aug;25(8):598-604. doi: 10.1714/4309.42929.
To date delirium prevalence in the adult acute Italian hospital cardiac population is unknown. In a multicenter study, we assessed the prevalence of delirium over a single day among a population of patients admitted to acute cardiac hospital wards in Italy.
This is a point prevalence study (called "Cardio Delirium Day") which involved 55 Italian cardiologic centers (23 North, 18 Central, 12 South, 2 Sardinia) that collected data on 152 patients older than 65 years hospitalized on March 15, 2023. Delirium was assessed on the same day in all patients using the Confusion Assessment Method for the Intensive Care Unit algorithm, a validated and briefly administered tool which does not require specialized training. We also collected data about clinical variables, functional and nutritional status, dementia, comorbidity, medications, and physical restraints.
The mean sample age was 79.0 ± 10 years (33% female). Delirium was diagnosed in 25 patients (16.4%); 17.1% were hospitalized in the intensive cardiac care unit and 13.8% in the cardiology ward (p=NS). Hyperactive was the commonest subtype (48%), followed by mixed (36%) and hypoactive type (8%). In a multivariate logistic regression, male sex (odds ratio [OR] 3.81, 95% confidence interval [CI] 1.18-12.26; p=0.025), chronic obstructive pulmonary disease (OR 0.24, 95% CI 0.063-0.66; p=0.008), sensorial deficit (OR 3.75, 95% CI 1.18-11.95; p=0.025), sleep deprivation (OR 5.81, 95% CI 1.47-22.9; p=0.012) and the presence of ≥3 precipitating factors (OR 7.63, 95% CI 2.32-25.2; p=0.001) were independent predictors of delirium.
Delirium occurred in 16.4% of patients in a cardiology setting. The "Cardio Delirium Day" project might become a useful method to assess delirium over time and sensitize the interest and the culture of Italian cardiology in this important aspect of hospital care.
迄今为止，意大利成人急性医院心脏科患者的谵妄患病率尚不清楚。在一项多中心研究中，我们评估了意大利急性心脏科病房收治患者群体中一天内谵妄的患病率。
这是一项现患率研究（称为“心脏谵妄日”），涉及55个意大利心脏病学中心（23个在北部，18个在中部，12个在南部，2个在撒丁岛），这些中心收集了2023年3月15日住院的152名65岁以上患者的数据。使用重症监护病房意识模糊评估方法算法在同一天对所有患者进行谵妄评估，该工具经过验证且使用简便，无需专门培训。我们还收集了有关临床变量、功能和营养状况、痴呆、合并症、药物治疗和身体约束的数据。
样本的平均年龄为79.0±10岁（女性占33%）。25名患者（16.4%）被诊断为谵妄；17.1%在心脏重症监护病房住院，13.8%在心脏病病房住院（p=无显著差异）。多动型是最常见的亚型（48%），其次是混合型（36%）和少动型（8%）。在多因素逻辑回归中，男性（比值比[OR]3.81，95%置信区间[CI]1.18 - 12.26；p=0.025）、慢性阻塞性肺疾病（OR 0.24，95% CI 0.063 - 0.66；p=0.008）、感觉缺陷（OR 3.75，95% CI 1.18 - 11.95；p=0.025）、睡眠剥夺（OR 5.81，95% CI 1.47 - 22.9；p=0.012）以及存在≥3个促发因素（OR 7.63，95% CI 2.32 - 25.2；p=0.001）是谵妄的独立预测因素。
在心脏病学环境中，16.4%的患者发生了谵妄。“心脏谵妄日”项目可能会成为一种有用的方法，用于长期评估谵妄，并提高意大利心脏病学对医院护理这一重要方面的关注和认识。
