Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults.
Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults.
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DOI：
10.1002/jhm.2077
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发表时间：
2013-09
影响因子：
2.6
通讯作者：
Inouye, Sharon K.
中科院分区：
文献类型：
--
作者：
Fick, Donna M.;Steis, Melinda R.;Waller, Jennifer L.;Inouye, Sharon K.
目前的文献没有明确老年人在急性护理住院期间和30天后潜在的认知障碍和精神错乱的重要性。描述与痴呆症叠加的偶发性精神错乱的发生率、危险因素和结果。社区医院24个月前瞻性队列研究139名患有痴呆症的老年人(65岁)这项前瞻性研究每天跟踪观察住院期间和出院后一个月的患者。主要测量指标包括痴呆症(改良幸福痴呆量表评分，智商代码)、日常精神状态变化、痴呆症分期/严重程度(临床痴呆量表，全球恶化程度量表)、妄想症(迷惑评估法)和妄想症严重程度(妄想症评定量表-98修订版)。所有统计分析采用SAS9.3和显著性检验，α水平为0.05。对年龄、性别、痴呆分期进行Logistic回归、协方差分析或线性回归分析。新发妄想的总发生率为32%(44/140)。精神错乱患者的短期死亡率为25%，住院时间延长，出院时功能较差。在一个月的随访中，精神错乱的受试者有更大的功能下降。男性更有可能发生精神错乱，痴呆症严重程度(全球恶化程度)每增加一个单位，受试者发生精神错乱的可能性就会增加1.5倍。精神错乱延长了痴呆症患者的住院时间。因此，增加对精神错乱的早期发现的干预措施有可能减少精神错乱的严重程度和持续时间，并防止因精神错乱的并发症和不必要的再入院而造成的不必要的痛苦和代价。
Current literature does not identify the significance of underlying cognitive impairment and delirium on older adults during and 30 days following acute care hospitalization. Describe the incidence, risk factors, and outcomes associated with incident delirium superimposed on dementia. 24-month prospective cohort study community hospital 139 older adults (>65 years) with dementia This prospective study followed patients daily during hospitalization and one month post-hospital. Main measures included dementia (Modified Blessed Dementia Rating Score, IQ CODE), daily mental status change, dementia stage/severity (Clinical Dementia Rating, Global Deterioration Scale), delirium (Confusion Assessment Method), and delirium severity (Delirium Rating Scale-Revised-98). All statistical analysis was performed using SAS 9.3 and significance with an alpha level of 0.05. Logistic regression, analysis of covariance or linear regression was performed controlling for age, gender and dementia stage. The overall incidence of new delirium was 32% (44/140). Those with delirium had a 25% short term mortality rate, increased length of stay and poorer function at discharge. At one month follow-up, subjects with delirium had greater functional decline. Males were more likely to develop delirium and for every one unit increase in dementia severity (Global Deterioration Scale), subjects were 1.5 times more likely to develop delirium. Delirium prolongs hospitalization for persons with dementia. Thus, interventions to increase early detection of delirium have the potential to decrease the severity and duration of delirium and to prevent unnecessary suffering and costs from the complications of delirium and unnecessary readmissions to the hospital.
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DOI：
10.1093/gerona/60.6.748
发表时间：
2005-06-01
影响因子：
5.1
作者：
Fick, DM;Kolanowski, AM;Inouye, SK
通讯作者：
Inouye, SK
影响因子：
14
作者：
通讯作者：
--
DOI：
10.1093/gerona/62.2.174
发表时间：
2007-02-01
影响因子：
5.1
作者：
Kiely, Dan K.;Jones, Richard N.;Marcantonio, Edward R.
通讯作者：
Marcantonio, Edward R.
影响因子：
10.6
作者：
ALEXOPOULOS, GS;ABRAMS, RC;SHAMOIAN, CA
通讯作者：
SHAMOIAN, CA
DOI：
10.1111/j.1532-5415.1983.tb03391.x
发表时间：
1983-01-01
影响因子：
6.3
作者：
KATZ, S
通讯作者：
KATZ, S