Risk factors for delirium in acutely admitted elderly patients: a prospective cohort study.
Risk factors for delirium in acutely admitted elderly patients: a prospective cohort study.
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DOI：
10.1186/1471-2318-5-6
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发表时间：
2005-04-13
期刊：
影响因子：
4.1
通讯作者：
de Rooij SE
中科院分区：
文献类型：
--
作者：
Korevaar JC;van Munster BC;de Rooij SE
谵妄是一种常见于老年住院患者的神经精神综合征，可以在任何医疗条件下发现。由于谵妄的严重后果，早期识别谵妄是重要的，以便及时开始治疗。尽管发生率很高，但谵妄的发生并不总是被确定为如此。了解潜在的风险因素很重要。本研究的目的是确定与急性入住内科病房的老年患者发生流行性谵妄相关的因素。所有65岁及以上的连续患者急性入院的内科学术医学中心，阿姆斯特丹，一所大学医院，被要求参加。谵妄的存在是确定在入院后48小时内由有经验的老年病学家。总共有126名患者被纳入，29%的患者在急性入院后普遍出现谵妄。与没有谵妄的患者相比，谵妄患者年龄更大，更常见的是认知和身体受损，更常见的是由于水和电解质紊乱而入院，而较少因恶性肿瘤或胃肠道出血而入院。急性入院后普遍谵妄的独立危险因素是病前认知障碍、功能障碍、尿素氮水平升高和白细胞数量。在这项研究中，最重要的独立危险因素，流行谵妄急性入院后的认知和身体损害，高血清尿素氮浓度。这些观察结果可能有助于早期识别和治疗谵妄急性入院老年患者。
Delirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition. Due to the severe consequences, early recognition of delirium is important in order to start treatment in time. Despite the high incidence rate, the occurrence of delirium is not always identified as such. Knowledge of potential risk factors is important. The aim of the current study is to determine factors associated with the occurrence of a prevalent delirium among elderly patients acutely admitted to an internal medicine ward. All consecutive patients of 65 years and over acutely admitted to the Department of Internal Medicine of the Academic Medical Centre, Amsterdam, a university hospital, were asked to participate. The presence of delirium was determined within 48 hrs after admission by an experienced geriatrician. In total, 126 patients were included, 29% had a prevalent delirium after acute admission. Compared to patients without delirium, patients with delirium were older, more often were cognitively and physically impaired, more often were admitted due to water and electrolyte disturbances, and were less often admitted due to malignancy or gastrointestinal bleeding. Independent risk factors for having a prevalent delirium after acute admission were premorbid cognitive impairment, functional impairment, an elevated urea nitrogen level, and the number of leucocytes. In this study, the most important independent risk factors for a prevalent delirium after acute admission were cognitive and physical impairment, and a high serum urea nitrogen concentration. These observations might contribute to an earlier identification and treatment of delirium in acutely admitted elderly patients.