Ferguson J A, Suelzer C J, Eckert G J, Zhou X H, Dittus R S
Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
J Gen Intern Med. 1996 Jul;11(7):410-4. doi: 10.1007/BF02600188.
To identify clinical characteristics associated with inpatient development of delirium tremens so that future treatment efforts can focus on patients most likely to benefit from aggressive therapy.
Retrospective cohort study among patients discharged with diagnoses related to alcohol abuse.
University-affiliated inner-city hospital.
PATIENTS/PARTICIPANTS: Two hundred consecutive patients discharged between June 1991 and August 1992 who underwent evaluation and treatment for alcohol withdrawal or detoxification.
Mean age was 41.9 years, 85% were male, 57% were white and 84% were unmarried. Forty-eight (24%) of the patients developed delirium tremens during hospitalization. Bivariate analysis indicated that those who developed delirium tremens were more likely to be African-American, unemployed, and homeless, and were more likely to have gone more days since their last drink, and to have concurrent acute medical illness, high admission blood urea nitrogen level and respiratory rate, and low admission albumin level and systolic blood pressure. In multiple logistic regression analyses, patients who developed delirium tremens were more likely to have gone more days since their last drink (odds ratio [OR] 1.3; 95% confidence interval [CI] 1.09, 1.61) and to have concurrent acute medical illness (OR 5.1; 95% CI 2.07, 12.55). These risk factors were combined for assessment of their ability to predict the occurrence of delirium tremens. If no factors were present, 9% developed delirium tremens; if one factor was present, 25% developed delirium tremens; and if two factors were present, 54% developed delirium tremens.
Inpatient development of delirium tremens was common among patients treated for alcohol detoxification or withdrawal and correlated with several readily available clinical variables.
确定与住院患者发生震颤谵妄相关的临床特征，以便未来的治疗工作能够聚焦于最有可能从积极治疗中获益的患者。
对诊断为酒精滥用并出院的患者进行回顾性队列研究。
大学附属市中心医院。
患者/参与者：1991年6月至1992年8月间连续出院的200例接受酒精戒断或解毒评估及治疗的患者。
平均年龄为41.9岁，85%为男性，57%为白人，84%未婚。48例（24%）患者在住院期间发生震颤谵妄。双变量分析表明，发生震颤谵妄的患者更可能是非裔美国人、失业、无家可归，且自上次饮酒后间隔时间更长，同时患有急性内科疾病、入院时血尿素氮水平和呼吸频率较高，以及入院时白蛋白水平和收缩压较低。在多因素逻辑回归分析中，发生震颤谵妄的患者自上次饮酒后间隔时间更长（比值比[OR]1.3；95%置信区间[CI]1.09，1.61），且同时患有急性内科疾病（OR 5.1；95%CI 2.07，12.55）。将这些危险因素综合起来评估其预测震颤谵妄发生的能力。若不存在危险因素，9%的患者发生震颤谵妄；若存在一个危险因素，25%的患者发生震颤谵妄；若存在两个危险因素，54%的患者发生震颤谵妄。
在接受酒精解毒或戒断治疗的患者中，住院期间发生震颤谵妄很常见，且与一些易于获得的临床变量相关。
