The impact of delirium in the intensive care unit on hospital length of stay.
The impact of delirium in the intensive care unit on hospital length of stay.
复制标题
重症监护病房中ir妄的影响对住院时间。
DOI：
10.1007/s00134-001-1132-2
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发表时间：
2001-12
影响因子：
38.9
通讯作者：
Inouye SK
中科院分区：
文献类型：
--
作者：
Ely EW;Gautam S;Margolin R;Francis J;May L;Speroff T;Truman B;Dittus R;Bernard R;Inouye SK
研究目的：确定重症监护病房(ICU)中的精神错乱与包括住院时间在内的预后的关系。设计：前瞻性队列研究。单位：成人医学ICU的三级护理，以大学为基础的医学中心。参与者：研究人群包括48名住进ICU的患者，其中24人接受了机械通气。测量：所有患者每天都由在精神错乱评估方面有专长的老年或精神病学专家使用美国精神病学协会的诊断统计手册IV(DSM-IV)标准进行评估，DSM-IV标准是精神错乱分级的参考标准。测量的主要结果是在ICU和医院的住院时间。结果：平均发病2.6天(S.D.±1.7)，平均持续3.4±1.9天。48例患者中，39例(81.3%)出现妄想，其中29例(60.4%)在ICU期间出现并发症。精神分裂症的持续时间与在ICU的住院时间(r=0.65，P=0.0001)和住院时间(r=0.68，P=0.0001)有关。通过多因素分析，即使在调整了病情严重程度、年龄、性别、种族、服用苯二氮卓类药物和麻醉药物的天数后，精神错乱仍是住院时间的最强预测因素(P=0.006)。结论：在这个患者队列中，大多数患者在ICU中发展为精神错乱，而精神错乱是住院时间最强的独立决定因素。有必要进一步研究和监测ICU中的精神错乱及其发展的危险因素。
Study objective: To determine the relationship between delirium in the intensive care unit (ICU) and outcomes including length of stay in the hospital. Design: A prospective cohort study. Setting: The adult medical ICU of a tertiary care, university-based medical center. Participants: The study population consisted of 48 patients admitted to the ICU, 24 of whom received mechanical ventilation. Measurements: All patients were evaluated for the development and persistence of delirium on a daily basis by a geriatric or psychiatric specialist with expertise in delirium assessment using the Diagnostic Statistical Manual IV (DSM-IV) criteria of the American Psychiatric Association, the reference standard for delirium ratings. Primary outcomes measured were length of stay in the ICU and hospital. Results: The mean onset of delirium was 2.6 days (S.D.±1.7), and the mean duration was 3.4±1.9 days. Of the 48 patients, 39 (81.3%) developed delirium, and of these 29 (60.4%) developed the complication while still in the ICU. The duration of delirium was associated with length of stay in the ICU (r=0.65, P=0.0001) and in the hospital (r=0.68, P<0.0001). Using multivariate analysis, delirium was the strongest predictor of length of stay in the hospital (P=0.006) even after adjusting for severity of illness, age, gender, race, and days of benzodiazepine and narcotic drug administration. Conclusions: In this patient cohort, the majority of patients developed delirium in the ICU, and delirium was the strongest independent determinant of length of stay in the hospital. Further study and monitoring of delirium in the ICU and the risk factors for its development are warranted.
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影响因子：
8.8
作者：
Ely, EW;Margolin, R;Inouye, SK
通讯作者：
Inouye, SK
影响因子：
39.2
作者：
Ely, EW;Evans, GW;Haponik, EF
通讯作者：
Haponik, EF
影响因子：
8.8
作者：
BLECK, TP;SMITH, MC;HANSEN, CA
通讯作者：
HANSEN, CA
影响因子：
120.7
作者：
FRANCIS, J;MARTIN, D;KAPOOR, WN
通讯作者：
KAPOOR, WN
DOI：
10.1111/j.1532-5415.1992.tb02111.x
发表时间：
1992-06-01
影响因子：
6.3
作者：
FRANCIS, J;KAPOOR, WN
通讯作者：
KAPOOR, WN