Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review.
Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review.
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DOI：
10.1001/jamanetworkopen.2022.49950
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发表时间：
2023-01-03
影响因子：
13.8
通讯作者：
Douglas, Vanja C.
中科院分区：
文献类型：
--
作者：
Ormseth, Cora H.;LaHue, Sara C.;Oldham, Mark A.;Josephson, S. Andrew;Whitaker, Evans;Douglas, Vanja C.
这篇系统的综述调查了与精神错乱相关的诱因和诱发因素。哪些诱因和诱发因素与精神错乱有关？在这项系统回顾的315项研究中，代表101名 144名患者，在所有环境和人群中，33个诱因和112个诱因与妄想有关。与这些因素相关的可能的病理生理机制是不同的。这项研究发现，在所有研究中都表现出生理异质性，这表明精神错乱可能并不局限于单一的生理原因。尽管导致精神错乱的病因不同，但在医院和临床试验中，它被视为一个共同的终点，而试图以同样的方式对待所有的精神错乱病例，可能会阻碍精神错乱的研究，使精神错乱的管理成为一种未得到满足的需求。根据诱发因素和沉淀物所反映的独特的妄想病理生理学模式进行个体化治疗可能是必要的，但目前尚无公认的方法将妄想分为不同的病因亚组。进行一项系统的回顾，以确定与环境不可知的成年患者的精神错乱相关的潜在易感和诱发因素。计算机检索PubMed、Embase、Web of Science和CogcINFO从数据库建立到2021年12月的文献，检索医学主题词目(MESH)中的意识障碍、困惑、因果关系和疾病易感性，限定条件为队列或病例对照研究。两位评价者选择了符合以下纳入标准的研究：以英语发表的前瞻性队列或病例对照研究，至少50名参与者，由医生或训练有素的研究人员使用参考标准亲自进行的精神错乱评估，以及包括确定与精神错乱相关的独立因素的多变量模型的结果。共纳入315项研究，纽卡斯尔-渥太华量表(SD)的平均得分为8.3分(0.8分)。在101例 患者中(男性50例 006(50.0%)，女性49例(49.1%) 766(49.1%))，有33项研究报告了与妄想有关的易感因素和112项诱发因素。与精神错乱相关的因素有很多，而且有很大的生理异质性。在这项系统的回顾中，在所有的临床环境中发现了一份与精神错乱相关的潜在诱因和诱发因素的综合清单。这些发现可能被用于更精确地研究精神分裂症的异质性病理生理学和治疗。
This systematic review investigates predisposing and precipitating factors associated with delirium. What predisposing and precipitating factors are associated with delirium? In this systematic review of 315 studies of delirium representing 101 144 patients across all settings and populations, 33 predisposing and 112 precipitating factors were associated with delirium. Putative pathophysiological mechanisms associated with these factors were heterogeneous. This study found physiological heterogeneity represented across studies, suggesting that delirium may not be not restricted to a singular physiological account. Despite discrete etiologies leading to delirium, it is treated as a common end point in hospital and in clinical trials, and delirium research may be hampered by the attempt to treat all instances of delirium similarly, leaving delirium management as an unmet need. An individualized approach based on unique patterns of delirium pathophysiology, as reflected in predisposing factors and precipitants, may be necessary, but there exists no accepted method of grouping delirium into distinct etiologic subgroups. To conduct a systematic review to identify potential predisposing and precipitating factors associated with delirium in adult patients agnostic to setting. A literature search was performed of PubMed, Embase, Web of Science, and PsycINFO from database inception to December 2021 using search Medical Subject Headings (MeSH) terms consciousness disorders, confusion, causality, and disease susceptibility, with constraints of cohort or case-control studies. Two reviewers selected studies that met the following criteria for inclusion: published in English, prospective cohort or case-control study, at least 50 participants, delirium assessment in person by a physician or trained research personnel using a reference standard, and results including a multivariable model to identify independent factors associated with delirium. A total of 315 studies were included with a mean (SD) Newcastle-Ottawa Scale score of 8.3 (0.8) out of 9. Across 101 144 patients (50 006 [50.0%] male and 49 766 [49.1%] female patients) represented (24 015 with delirium), studies reported 33 predisposing and 112 precipitating factors associated with delirium. There was a diversity of factors associated with delirium, with substantial physiological heterogeneity. In this systematic review, a comprehensive list of potential predisposing and precipitating factors associated with delirium was found across all clinical settings. These findings may be used to inform more precise study of delirium’s heterogeneous pathophysiology and treatment.
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DOI：
10.1177/0267659109358207
发表时间：
2009-11
期刊：
Perfusion
影响因子：
--
作者：
Rudolph JL;Babikian VL;Treanor P;Pochay VE;Wigginton JB;Crittenden MD;Marcantonio ER
通讯作者：
Marcantonio ER
影响因子：
2.9
作者：
Cai, Shining;Latour, Jos M.;Zhang, Yuxia
通讯作者：
Zhang, Yuxia
影响因子：
3
作者：
Angles, Erik M.;Robinson, Thomas N.;Moore, Ernest E.
通讯作者：
Moore, Ernest E.
影响因子：
6.3
作者：
Beishuizen, Sara J. E.;Scholtens, Rikie M.;de Rooij, Sophia E.
通讯作者：
de Rooij, Sophia E.
影响因子：
9
作者：
Böhner, H;Hummel, TC;Schneider, F
通讯作者：
Schneider, F