Risk factors for delirium after major trauma
Risk factors for delirium after major trauma
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DOI：
10.1016/j.amjsurg.2008.07.037
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发表时间：
2008-12-01
影响因子：
3
通讯作者：
Moore, Ernest E.
中科院分区：
文献类型：
--
作者：
Angles, Erik M.;Robinson, Thomas N.;Moore, Ernest E.
背景技术背景：本研究的目的是描述严重损伤后谵妄的自然史，以确定危险因素，预测损伤后，谵妄的发展，并比较受试者和无delirium.METHODS：一项前瞻性研究进行了8或更高的创伤严重程度评分入院的创伤重症监护室（ICU）的一级创伤中心的患者。患者进行日常评估谵妄的混乱评估方法-ICU.RESULTS：69例患者（53名男性）入组。41例（59%）受试者发生谵妄。Logistic回归发现到达时格拉斯哥昏迷评分较低（12 +/- 1.0 vs 15 +/- .1; P < .01），输血量增加（2.8 +/-.7vs.5 +/- .3; P < .01），多器官功能衰竭评分较高（1.2 +/-.2vs.1 +/- .1; P <.01）是发生谵妄的最强预测因子。结果指标显示，谵妄患者住院时间较长，ICU住院时间较长，更有可能需要出院后institutionalization.CONCLUSIONS：谵妄是常见的创伤ICU。较高的多器官功能衰竭评分是损伤后谵妄的最强预测因子。(C)2008年由Elsevier Inc.出版
BACKGROUND: This study aimed to describe the natural history of delirium after major injury, to identify risk factors that predict the development of postinjury, delirium, and to compare outcome measures in subjects with and without delirium.METHODS: A prospective study was performed on patients with an injury severity score of 8 or higher admitted to the trauma intensive care unit (ICU) of a level I trauma center. Patients underwent daily assessments for delirium with the Confusion Assessment Method-ICU.RESULTS: Sixty-nine patients (53 male) were enrolled. Delirium occurred in 41 (59%) subjects. Logistic regression found lower arrival Glasgow Coma Score (12 +/- 1.0 vs 15 +/- .1; P < .01), increased blood transfusions (2.8 +/- .7 vs .5 +/- .3; P < .01), and higher multiple organ failure score (1.2 +/- .2 vs vs .1 +/- .1; P < .0 1) to be the strongest predictors for developing delirium. Outcome measures revealed subjects with delirium had longer hospital stays, longer ICU stays, and were more likely require postdischarge institutionalization.CONCLUSIONS: Delirium is common in the trauma ICU. Higher multiple organ failure score was the strongest predictor of postinjury delirium. (C) 2008 Published by Elsevier Inc.