Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis.
Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis.
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DOI：
10.1093/ageing/afu022
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发表时间：
2014-05
期刊：
影响因子：
6.7
通讯作者：
Sampson EL
中科院分区：
文献类型：
--
作者：
Ahmed S;Leurent B;Sampson EL
背景：高达40%的老年住院患者神志不清，但尚未有系统的综述关注老年内科住院患者神志不清的危险因素。我们的目标是综合关于偶发精神错乱的危险因素的数据，并在可能的情况下对这些因素进行荟萃分析。方法：应用计算机检索PubMed和Web of Science数据库(1987-01/2013-08)。研究使用纽卡斯尔-渥太华量表进行质量评级。我们使用Mantel-Haenszel和逆方差方法估计单个危险因素的合并优势比(OR)或平均差异。结果：11篇文献符合纳入标准，纳入综述。总研究人数2338人(411名妄想症患者/1927名对照)。与精神错乱显著相关的最常见因素是痴呆症、年龄较大、合并疾病、内科疾病严重程度、感染、“高风险”药物使用、日常生活活动减少、行动不便、感觉障碍、导尿、尿素和电解质失衡以及营养不良。在合并分析中，痴呆(OR 6.62；95%CI(可信区间)4.30，10.19)、疾病严重程度(APACHE II)(MD(均值差)3.91；95%CI 2.22，5.59)、视力损害(OR 1.89；95%CI 1.03，3.47)、导尿(OR 3.16；95%CI 1.26，7.92)、低白蛋白水平(MD−3.14；95%CI−5.99，−0.29)和住院时间(OR 4.85；95%可信区间为2.20，7.50)，差异有统计学意义。结论：我们确定了与入院后偶发精神错乱相关的危险因素。这些因素有助于突出老年急性内科住院患者在住院期间发生精神错乱的风险。
Background: delirium affects up to 40% of older hospitalised patients, but there has been no systematic review focussing on risk factors for incident delirium in older medical inpatients. We aimed to synthesise data on risk factors for incident delirium and where possible conduct meta-analysis of these. Methods: PubMed and Web of Science databases were searched (January 1987–August 2013). Studies were quality rated using the Newcastle-Ottawa Scale. We used the Mantel–Haenszel and inverse variance method to estimate the pooled odds ratio (OR) or mean difference for individual risk factors. Results: eleven articles met inclusion criteria and were included for review. Total study population 2338 (411 patients with delirium/1927 controls). The commonest factors significantly associated with delirium were dementia, older age, co-morbid illness, severity of medical illness, infection, ‘high-risk’ medication use, diminished activities of daily living, immobility, sensory impairment, urinary catheterisation, urea and electrolyte imbalance and malnutrition. In pooled analyses, dementia (OR 6.62; 95% CI (confidence interval) 4.30, 10.19), illness severity (APACHE II) (MD (mean difference) 3.91; 95% CI 2.22, 5.59), visual impairment (OR 1.89; 95% CI 1.03, 3.47), urinary catheterisation (OR 3.16; 95% CI 1.26, 7.92), low albumin level (MD −3.14; 95% CI −5.99, −0.29) and length of hospital stay (OR 4.85; 95% CI 2.20, 7.50) were statistically significantly associated with delirium. Conclusion: we identified risk factors consistently associated with incident delirium following admission. These factors help to highlight older acute medical inpatients at risk of developing delirium during their hospital stay.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
DOI：
10.1016/s0897-1897(05)80132-6
发表时间：
1990-08-01
期刊：
Applied nursing research : ANR
影响因子：
--
作者：
Vermeersch, P E
通讯作者：
Vermeersch, P E
影响因子：
4
作者：
Wilson, K;Broadhurst, C;Mottram, P
通讯作者：
Mottram, P
影响因子：
6.7
作者：
OKeeffe, ST;Lavan, JN
通讯作者：
Lavan, JN
影响因子：
39.2
作者：
INOUYE, SK;VISCOLI, CM;TINETTI, ME
通讯作者：
TINETTI, ME