Kodama Lay, Woldemariam Sarah R, Tang Alice S, Li Yaqiao, Kornak John, Allen Isabel Elaine, Raphael Eva, Oskotsky Tomiko T, Sirota Marina
Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA.
Medical Scientist Training Program, University of California San Francisco, San Francisco, CA, USA.
Commun Med (Lond). 2025 Jul 22;5(1):304. doi: 10.1038/s43856-025-00986-5.
Delirium is a mental condition defined as fluctuating disturbances in attention, awareness, and cognition. It is often seen in older, hospitalized patients and is currently hard to predict, with long- and short-term outcomes being detrimental to patients.
We leveraged electronic health records (EHR) to identify 7492 UCSF patients and 19,417 UC health system patients with an inpatient delirium diagnosis and the same number of control patients without delirium. We used the Fisher's exact test with multiple corrections for the association studies and the Cox regression model for the longitudinal analyses.
Here we show significant associations between comorbidities or laboratory values and an inpatient delirium diagnosis, including metabolic abnormalities and psychiatric diagnoses. Some associations are sex-specific, including dementia subtypes and infections. We further explore the associations with anemia and bipolar disorder by conducting longitudinal analyses from the time of first diagnosis to development of delirium, demonstrating a significant relationship across time. Finally, we show that an inpatient delirium diagnosis leads to increased risk of mortality.
These results demonstrate the powerful application of the EHR to shed insights into prior diagnoses and laboratory values that could help predict development of inpatient delirium and the importance of sex when making these assessments.
谵妄是一种精神状态，被定义为注意力、意识和认知的波动紊乱。它在老年住院患者中很常见，目前难以预测，其长期和短期后果对患者都不利。
我们利用电子健康记录（EHR）识别出7492名加州大学旧金山分校的患者和19417名加州大学健康系统的患者，这些患者被诊断为住院谵妄，同时选取了相同数量的无谵妄对照患者。我们在关联研究中使用了经多次校正的Fisher精确检验，并在纵向分析中使用了Cox回归模型。
在此我们展示了合并症或实验室检查值与住院谵妄诊断之间的显著关联，包括代谢异常和精神疾病诊断。一些关联存在性别差异，包括痴呆亚型和感染。我们通过从首次诊断到谵妄发生进行纵向分析，进一步探讨了与贫血和双相情感障碍的关联，结果表明随时间推移存在显著关系。最后，我们表明住院谵妄诊断会导致死亡风险增加。
这些结果证明了电子健康记录在深入了解先前诊断和实验室检查值方面的强大应用，这些信息有助于预测住院谵妄的发生，以及在进行这些评估时性别的重要性。
