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印度中部一家三级护理医院谵妄精神科转诊患病率及临床特征的二次分析

A Secondary Analysis of the Prevalence and Clinical Profile of Psychiatric Referrals of Delirium in a Tertiary Care Hospital in Central India.

作者信息

Mishra Saloni, Mudgal Varchasvi, Mathur Rahul, Niranjan Vijay, Pal Virendra

机构信息

Psychiatry, Mahatma Gandhi Memorial (M.G.M) Medical College, Indore, IND.

出版信息

Cureus. 2024 Nov 29;16(11):e74797. doi: 10.7759/cureus.74797. eCollection 2024 Nov.

Abstract

INTRODUCTION

Delirium is a common and serious neuropsychiatric syndrome characterized by acute, fluctuating alterations in consciousness, cognition, and perception. It is associated with increased morbidity, mortality, length of hospital stays, and healthcare costs.

AIM

The aim of this study was to assess the prevalence and clinical profile of psychiatric referrals of delirium in a tertiary-care hospital.

METHODS

A secondary analysis was conducted on patients with delirium referred to the CLP Unit, Department of Psychiatry, between June 2022 and June 2023. A comprehensive analysis was done using descriptive statistics to summarize the data, independent t-tests to compare group means, and chi-square tests to examine associations between categorical variables, providing a robust evaluation of the key relationships and patterns.

RESULTS

The key findings indicate that the psychiatric referral rate was about 2.98% from various departments. The prevalence of delirium in our hospital was 13.2% of the total psychiatric referrals and about 0.4% of the total inpatients of the tertiary care hospital during the study duration. The mean age of delirium patients in the geriatric and non-geriatric groups was 71.6 years and 37.9 years, respectively. Most referrals were from the medicine department. Metabolic disorders and substance use were the most common physical and psychiatric comorbidities, respectively. Psychotropic use with supportive intervention was common (60.3%), with antipsychotics being the most commonly used class of psychotropics.

CONCLUSION

Delirium is a prevalent and clinically diverse syndrome that affects a significant proportion of hospitalized patients. It is a multidimensional disorder impacting a range of populations. Physical and psychiatric comorbidities play an important role in prognosis. While psychotropic use may be helpful symptomatically, it is not associated with better outcomes. Treating the underlying cause remains of paramount importance.

摘要

引言

谵妄是一种常见且严重的神经精神综合征,其特征为意识、认知和感知的急性、波动性改变。它与发病率、死亡率、住院时间延长及医疗费用增加相关。

目的

本研究旨在评估三级医院中谵妄精神科转诊的患病率及临床特征。

方法

对2022年6月至2023年6月间转诊至精神科CLP病房的谵妄患者进行二次分析。使用描述性统计对数据进行全面分析,以总结数据,使用独立t检验比较组均值,使用卡方检验检查分类变量之间的关联,从而对关键关系和模式进行有力评估。

结果

主要研究结果表明,各科室精神科转诊率约为2.98%。在研究期间,我院谵妄患病率占精神科总转诊患者的13.2%,占三级医院总住院患者的约0.4%。老年组和非老年组谵妄患者的平均年龄分别为71.6岁和37.9岁。大多数转诊来自内科。代谢紊乱和物质使用分别是最常见的躯体和精神合并症。使用精神药物并辅以支持性干预很常见(60.3%),其中抗精神病药物是最常用的精神药物类别。

结论

谵妄是一种普遍且临床多样的综合征,影响着相当比例的住院患者。它是一种影响一系列人群的多维度疾病。躯体和精神合并症在预后中起重要作用。虽然使用精神药物可能在症状上有所帮助,但与更好的预后无关。治疗潜在病因仍然至关重要。

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Epidemiology and risk factors for delirium across hospital settings.医院环境中谵妄的流行病学和危险因素。
Best Pract Res Clin Anaesthesiol. 2012 Sep;26(3):277-87. doi: 10.1016/j.bpa.2012.07.003.
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The importance of delirium: economic and societal costs.谵妄的重要性:经济和社会成本。
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