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[综合医院收治老年患者的谵妄情况]

[Delirium in an elderly population admitted at a general hospital].

作者信息

Lázaro L, Marcos T, Cirera E, Pujol J

机构信息

Subdivisión de Psiquiatría y Psicología Médica, Hospital Clínic i Provincial, Barcelona.

出版信息

Med Clin (Barc). 1995 Mar 11;104(9):329-33.

PMID:7731300
Abstract

BACKGROUND

Delirium is an organic mental disorder frequently seen in elderly patients admitted to hospital for medical or surgical diseases. The prevalence, triggering factors, the relationship with prior existence of dementia and the evolution of delirium were studied.

METHODS

One hundred eight elderly patients admitted to the Internal Medicine, General Surgery and Traumatology Departments of the Hospital Clínic i Provincial in Barcelona, Spain were randomly selected with clinical evaluation being performed following the DSM-III-R diagnostic criteria. Likewise a structured clinical interview (CAMDEX) was carried out, and the establishment of delirium, the possible causes and its evolution were evaluated.

RESULTS

Eighteen of the elderly patients studied presented delirium at some time during hospital stay. Of these patients 15 had previously been clinically diagnosed with dementia. These patients did not require longer hospital stay than those not presenting dementia. The most frequent etiology was surgery and fever due to an infectious process. In addition to etiologic treatment, 12 of the patients also received symptomatic treatment with a neuroleptic drug (haloperidol).

CONCLUSIONS

Most of the elderly who have presented delirium admitted in a general hospital had been diagnosed with dementia during hospital stay thus indicating the high comorbidity of the two entities. In many cases it is important to carry out symptomatic in addition to etiologic treatment to achieve rapid reversibility of the disorder.

摘要

背景

谵妄是一种器质性精神障碍,常见于因内科或外科疾病住院的老年患者。本研究探讨了谵妄的患病率、诱发因素、与既往痴呆的关系以及谵妄的演变情况。

方法

随机选取西班牙巴塞罗那市省立医院临床医院内科、普通外科和创伤科收治的108例老年患者,按照DSM-III-R诊断标准进行临床评估。同时进行结构化临床访谈(CAMDEX),评估谵妄的发生、可能原因及其演变。

结果

在所研究的老年患者中,18例在住院期间的某个时间出现谵妄。其中15例患者此前临床诊断为痴呆。这些患者的住院时间并不比未患痴呆的患者长。最常见的病因是手术和感染性发热。除病因治疗外,12例患者还接受了抗精神病药物(氟哌啶醇)的对症治疗。

结论

综合医院收治的出现谵妄的老年患者中,大多数在住院期间被诊断为痴呆,这表明这两种疾病的高共病率。在许多情况下,除病因治疗外,进行对症治疗对于实现疾病的快速逆转很重要。

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