内科住院患者的认知障碍。II：医生是否会漏诊认知障碍？
Cognitive impairment in medical inpatients. II: Do physicians miss cognitive impairment?
作者信息
Harwood D M, Hope T, Jacoby R
机构信息
Section of Old Age Psychiatry, University of Oxford Department of Psychiatry, Warneford Hospital, UK.
出版信息
Age Ageing. 1997 Jan;26(1):37-9. doi: 10.1093/ageing/26.1.37.
AIM
to study the recognition of cognitive impairment in elderly medical inpatients by medical staff.
METHODS
201 patients over 65 were assessed by administration of standard cognitive screening tests and an interview with relatives. We made Diagnostic and Statistical Manual (DSM) IIIR diagnoses of various causes of cognitive impairment and clinical diagnoses for those patients not fulfilling DSM IIIR criteria. Medical notes were scrutinized for any mention of cognitive impairment.
RESULTS
46% of the patients found to be cognitively impaired by the researcher had no record of cognitive impairment in the medical notes. However, 14 out of 15 of the patients with DSM IIIR delirium, and 22 out of the 26 patients with DSM IIIR dementia, were identified as cognitively impaired by the physicians. This suggests that the physicians were detecting the vast majority of patients with clinically significant cognitive impairment.
目的
研究医务人员对老年内科住院患者认知障碍的识别情况。
方法
对201名65岁以上的患者进行了标准认知筛查测试，并与亲属进行了访谈。我们根据《精神疾病诊断与统计手册》（DSM）IIIR对各种认知障碍病因进行了诊断，并对不符合DSM IIIR标准的患者进行了临床诊断。仔细查阅病历以查找任何有关认知障碍的记录。
结果
研究人员发现存在认知障碍的患者中，46%在病历中没有认知障碍记录。然而，15名患有DSM IIIR谵妄的患者中有14名，以及26名患有DSM IIIR痴呆的患者中有22名，被医生识别为认知障碍。这表明医生能够识别出绝大多数具有临床显著意义的认知障碍患者。
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