Postoperative delirium: a 76-year-old woman with delirium following surgery.
Postoperative delirium: a 76-year-old woman with delirium following surgery.
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DOI：
10.1001/jama.2012.6857
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发表时间：
2012-07-04
影响因子：
120.7
通讯作者：
Marcantonio, Edward R.
中科院分区：
文献类型：
--
作者：
Marcantonio, Edward R.
谵妄（急性意识模糊）使15%至50%的老年人重大手术复杂化，并与其他重大术后并发症、住院时间延长、功能恢复不良、机构化、痴呆和死亡相关。重要的是，谵妄可能是可预测的，可以通过积极干预来预防。然而，临床医生未能认识到和解决术后谵妄的病例高达80%。使用的情况下，女士R，一个76岁的女人谁开发谵妄第一次结肠切除术后并发症，并再次常规手术后，谵妄的诊断，预防和治疗在术后设置进行审查。术后谵妄的风险可以通过诱发因素和促发因素的总和来量化。成功预防和治疗谵妄的策略包括针对可逆性风险因素的积极多因素干预，限制镇静药物（尤其是苯二氮卓类）的使用，有效管理术后疼痛，以及可能明智地使用抗精神病药物。
Delirium (acute confusion) complicates 15% to 50% of major operations in older adults and is associated with other major postoperative complications, prolonged length of stay, poor functional recovery, institutionalization, dementia, and death. Importantly, delirium may be predictable and preventable through proactive intervention. Yet clinicians fail to recognize and address postoperative delirium in up to 80% of cases. Using the case of Ms R, a 76-year-old woman who developed delirium first after colectomy with complications and again after routine surgery, the diagnosis, prevention, and treatment of delirium in the postoperative setting is reviewed. The risk of postoperative delirium can be quantified by the sum of predisposing and precipitating factors. Successful strategies for prevention and treatment of delirium include proactive multifactorial intervention targeted to reversible risk factors, limiting use of sedating medications (especially benzodiazepines), effective management of postoperative pain, and, perhaps, judicious use of antipsychotics.
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del妄作为重症疾病幸存者长期认知障碍的预测指标。
影响因子：
8.8
作者：
Girard TD;Jackson JC;Pandharipande PP;Pun BT;Thompson JL;Shintani AK;Gordon SM;Canonico AE;Dittus RS;Bernard GR;Ely EW
通讯作者：
Ely EW
DOI：
10.1016/j.jamcollsurg.2011.05.004
发表时间：
2011-08-01
影响因子：
5.2
作者：
Chen, Cheryl Chia-Hui;Lin, Ming-Tsan;Inouye, Sharon K.
通讯作者：
Inouye, Sharon K.
影响因子：
8.8
作者：
Devlin, John W.;Roberts, Russel J.;Garpestad, Erik
通讯作者：
Garpestad, Erik
影响因子：
9
作者：
Böhner, H;Hummel, TC;Schneider, F
通讯作者：
Schneider, F
影响因子：
8.8
作者：
Girard TD;Pandharipande PP;Carson SS;Schmidt GA;Wright PE;Canonico AE;Pun BT;Thompson JL;Shintani AK;Meltzer HY;Bernard GR;Dittus RS;Ely EW;MIND Trial Investigators
通讯作者：
MIND Trial Investigators