Altered mental status in older patients in the emergency department.

Altered mental status in older patients in the emergency department.
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DOI:
10.1016/j.cger.2012.09.005
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发表时间:
2013-02
影响因子:
3.3
通讯作者:
Wilber ST
Wilber ST
中科院分区:
医学3区
文献类型:
--
作者:
Han JH;Wilber ST

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精神状态改变是老年急诊科(ED)患者常见的主要主诉。精神状态的急性改变更令人担忧,通常继发于谵妄、木僵和昏迷。这些形式的急性脑功能障碍通常由潜在的内科疾病引发,这些疾病可能危及生命,并与多种不良后果相关。虽然木僵和昏迷很容易识别,但谵妄的临床表现可能很微妙,如果不积极进行筛查,往往会被遗漏。对于急性脑功能障碍患者,急诊科的评估应重点寻找潜在病因。感染是谵妄最常见的诱因之一,但可能同时存在多种病因。
Altered mental status is a common chief complaint among older emergency department (ED) patients. Acute changes in mental status are more concerning and are usually secondary to delirium, stupor, and coma. These forms of acute brain dysfunction are commonly precipitated by an underlying medical illness that can be potentially life-threatening and are associated with a multitude of adverse outcomes. Though stupor and coma are easily identifiable, the clinical presentation of delirium can be subtle and is often missed without actively screening for it. For patients with acute brain dysfunction, the ED evaluation should focus on searching for the underlying etiology. Infection is one of the most common precipitants of delirium, but multiple etiologies may exist concurrently.
DOI: 10.1097/00003246-199310000-00012
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