Delirium in an intensive care unit: a study of risk factors
Delirium in an intensive care unit: a study of risk factors
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DOI：
10.1007/s001340101017
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发表时间：
2001-08-01
影响因子：
38.9
通讯作者：
Skrobik, Y
中科院分区：
文献类型：
--
作者：
Dubois, MJ;Bergeron, N;Skrobik, Y
目的：（1）确定重症监护病房（ICU）中谵妄发生的危险因素;（2）确定谵妄对发病率、死亡率和住院时间的影响。设计：前瞻性研究。设置：一所大学医院的16张内科/外科ICU床位。患者：在5个月内，有216名连续入住ICU超过24小时的患者被纳入本研究。记录病史、选定的实验室检查值、接受的药物以及可能影响患者心理和情绪健康的因素。所有患者均采用谵妄量表进行筛查。精神科医生证实了谵妄的诊断。主要并发症，如自我拔管和导管的去除，以及死亡率和住院时间recorded.Results：40例患者（19%）发生谵妄，其中，三分之一没有激动。多因素分析中高血压、吸烟史、胆红素水平异常。硬膜外麻醉和吗啡的使用与谵妄有统计学显著相关。传统的因素与发展谵妄对普通病房的患者并不显着在我们的研究Morcidity（自我拔管和移除导管），但不是死亡率，明显increasing.Conclusion：预测危险因素的发展谵妄在ICU以外的研究可能不适用于危重患者。谵妄与发病率增加有关。意识到患者的风险可能会导致更好的识别和早期干预。
Objectives: (1) To establish risk factors for the development of delirium in an intensive care unit (ICU) and (2) to determine the effect of delirium on morbidity, mortality and length of stay.Design: Prospective study.Setting: Sixteen-bed medical/surgical ICU in a university hospital.Patients: Two hundred and sixteen consecutive patients admitted to the ICU for more than 24 h during 5 months were included in the study.Interventions: Medical history, selected laboratory values, drugs received and factors that may influence patient psychological and emotional well-being were noted. All patients were screened with a delirium scale. A psychiatrist confirmed the diagnosis of delirium. Major complications such as self-extubation and removal of catheters, as well as mortality and length of stay were recorded.Results: Forty patients (19 %) developed delirium-, of these, one-third were not agitated. In the multivariate analysis hypertension, smoking history, abnormal bilirubin level. epidural use and morphine were statistically significantly associated with delirium. Traditional factors associated with the development of delirium on general ward patients were not significant in our study Morbidity (self-extubation and removal of catheters), but not mortality, was clearly increased.Conclusion: Predictive risk factors for the development of delirium in studies outside the ICU may not be applicable to critically ill patients. Delirium is associated with increased morbidity. Awareness of patients at risk may lead to better recognition and earlier intervention.