Department of Evidence-Based Nursing Research Laboratory, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Department of Geriatrics, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Sci Rep. 2024 Aug 21;14(1):19454. doi: 10.1038/s41598-024-69925-z.
During the COVID-19 pandemic, delirium became a major complication that worsened patient outcomes. However, the factors influencing the severity of delirium in patients with COVID-19 have not been determined. We conducted this study to detect influencing factors associated with subtypes of delirium in patients with COVID-19. We included 1774 adult inpatients with COVID-19 from January to February 2023 at 7 sites in China. And used the 3 min Confusion Assessment Method and the Richmond Agitation-Sedation Scale for site assessment to identify and classify subtypes of delirium. Laboratory data were obtained from the Hospital Information System. After multivariate analysis, hypoactive delirium was significantly associated with age, the serum albumin concentration, frailty and sarcopenia, and health and nutritional status. Mixed delirium was significantly associated with age, D-dimer level, sarcopenia, health status and nutritional status. Additionally, hyperactive delirium was significantly associated with age, procalcitonin levels, frailty status and health status. Our findings suggest that poor nutritional status and low serum albumin concentration can help detect patients at high risk of developing hypoactive and mixed delirium. Additionally, clinical staff should pay more attention to patients with inflammatory conditions to assess and detect delirium because many influencing factors are involved in the common pathological mechanism of inflammation.
在 COVID-19 大流行期间，谵妄成为一种主要的并发症，使患者的预后恶化。然而，影响 COVID-19 患者谵妄严重程度的因素尚未确定。我们进行这项研究是为了检测与 COVID-19 患者谵妄亚型相关的影响因素。我们纳入了 2023 年 1 月至 2 月期间中国 7 个地点的 1774 名成年 COVID-19 住院患者。使用 3 分钟意识混乱评估法和 Richmond 躁动-镇静量表进行现场评估，以识别和分类谵妄亚型。实验室数据来自医院信息系统。经过多变量分析，低反应性谵妄与年龄、血清白蛋白浓度、虚弱和肌少症以及健康和营养状况显著相关。混合性谵妄与年龄、D-二聚体水平、肌少症、健康状况和营养状况显著相关。此外，高反应性谵妄与年龄、降钙素原水平、虚弱状态和健康状况显著相关。我们的研究结果表明，营养不良和低血清白蛋白浓度可帮助检测易发生低反应性和混合性谵妄的高危患者。此外，临床工作人员应更加关注有炎症情况的患者，以评估和检测谵妄，因为许多影响因素涉及炎症的共同病理机制。
