Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized.
Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized.
复制标题
物理和职业疗法对住院老年急诊科患者的ir妄期限的影响。
DOI：
10.1002/emp2.12857
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发表时间：
2023-03
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
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作者：
老年急诊科（艾德）成人的谵妄与长期身体功能和认知能力较差相关。我们试图评估物理和/或职业治疗（PT/OT）的时间和强度是否与艾德谵妄住院的持续时间（艾德谵妄持续时间）相关。这是2012年3月至2014年11月在一家城市、学术、三级保健医院进行的前瞻性队列研究的二次分析。纳入了到艾德就诊且在住院期间接受PT/OT治疗的年龄≥65岁的患者。从病历中提取从入组至首次PT/OT治疗的天数以及PT/OT持续时间相对于住院时间（PT/OT强度）。艾德谵妄持续时间定义为使用简明精神错乱评估方法在艾德中检测到的谵妄持续时间。数据分析采用比例优势逻辑回归调整多个变量。计算校正比值比（OR），95%置信区间（95%CI）。PT/OT强度的中位对数为0.5%（四分位距[IQR]：0.3%，0.9%），与谵妄持续时间较短相关（校正OR，0.39; 95% CI，0.21-0.73）。至首次PT/OT治疗的中位时间为2天（IQR：1，3天），与谵妄持续时间无关（校正OR，1.02; 95% CI，0.82-1.27）。在老年住院患者中，较高的PT/OT强度可能是缩短谵妄持续时间的有效干预措施。至首次PT/OT治疗的时间与谵妄持续时间无关，但在艾德就诊后整整2天开始。
Delirium in older emergency department (ED) adults is associated with poorer long‐term physical function and cognition. We sought to evaluate if the time to and intensity of physical and/or occupational therapy (PT/OT) are associated with the duration of ED delirium into hospitalization (ED delirium duration). This is a secondary analysis of a prospective cohort study conducted from March 2012 to November 2014 at an urban, academic, tertiary care hospital. Patients aged ≥65 years presenting to the ED and who received PT/OT during their hospitalization were included. Days from enrollment to the first PT/OT session and PT/OT duration relative to hospital length of stay (PT/OT intensity) were abstracted from the medical record. ED delirium duration was defined as the duration of delirium detected in the ED using the Brief Confusion Assessment Method. Data were analyzed using a proportional odds logistic regression adjusted for multiple variables. Adjusted odds ratios (ORs) were calculated with 95% confidence intervals (95%CI). The median log PT/OT intensity was 0.5% (interquartile range [IQR]: 0.3%, 0.9%) and was associated with shorter delirium duration (adjusted OR, 0.39; 95% CI, 0.21–0.73). The median time to the first PT/OT session was 2 days (IQR: 1, 3 days) and was not associated with delirium duration (adjusted OR, 1.02; 95% CI, 0.82–1.27). In older hospitalized adults, higher PT/OT intensity may be a useful intervention to shorten delirium duration. Time to first PT/OT session was not associated with delirium duration but was initiated a full 2 days after the ED presentation.