OUTCOMES OF DELIRIUM IN HOSPITALIZED ELDERLY

精神错乱可能是一种急性内科疾病的并发症 30%的住院老年人。然而，很少有研究涉及到 其流行病学、风险因素或自然病史( 标准、统一的案例确定和对潜力的关注 混血儿。我们假设精神错乱的发生 确定了一组患有体内平衡障碍的虚弱老年人 可能会在临床上得到认可。这样的患者很可能 长期死亡的风险增加，认知能力下降， 和功能障碍。 这项研究将检查发病率、流行率和长期 住院社区老年人精神错乱的预后 大学医院普通内科病房。行为 精神错乱的指标将通过筛选所有符合条件的人来确定 每隔48小时入院一次，足以让他们在医院住上一天。这个 是否存在DSM-III-R精神错乱标准将通过以下方式确定 一位老年病学家，并由一位老年精神病学家独立确认。 精神错乱与潜在危险因素的关系，如年龄、 性别、社会支持、身体功能、疾病严重程度和急性 并对慢性疾病进行检查。对于 在这项研究的纵向阶段，将汇集两个队列- 一例精神错乱病例，另一例由匹配的对照组组成 年龄、性别和入院类型(紧急或选择性)-两者都有 小组将每隔6个月进行一次跟踪，总计2年 为了确定长期死亡率的差异， 制度化，以及功能和认知能力的下降。 生存分析我们研究了精神错乱与长期精神障碍的关系 长期结果，控制已知的影响这些的变量 结果。如果精神错乱是一个独立的危险因素 在老年人的机能能力方面，这些信息将是有用的 指导对虚弱老年人的干预，并协助规划 进行临床试验以预防或改善糖尿病的后果。 住院病人的精神错乱。

Delirium may be a complication of acute medical illness in up to 30% of hospitalized elderly. Few studies, however, have addressed its epidemiology, risk factors, or natural history with strict( criteria, uniform case ascertainment, and attention to potential confounders. We hypothesize that the occurrence of delirium identifies a group of frail elder with homeostatic impairment that might otherwise go clinically recognized. Such patients are likely to be at increase risk for long-term mortality, cognitive decline, and functional impairment. This study will examine the incidence, prevalence, and long-term prognosis of delirium among community-dwelling elderly admitted to general medical wards of university hospital. Behavioral indicators of delirium will be determined by screening all eligible admissions at 48 hour intervals enough their hospital stay. The presence of DSM-III-R criteria for delirium will be determined by a geriatrician and confirmed independently by a geropsychiatrist. The relation of delirium to potential risk factors such as age, sex, social support physical function, illness severity, and acute and chronic medical conditions will be examined. For the longitudinal phase of this study, two cohorts will be assembled - one of delirium cases, and a second consisting of controls matched for age, sex, and type of admission (emergency or elective)- Both groups will be followed at 6-month intervals for a total of 2 years to determine differences in long-term mortality, rates of institutionalization, and functional and cognitive decline. Survival analysis we examine the relationship of delirium to long- term outcomes, controlling for variables known to influence these outcomes. If delirium is an independent risk factor for loss of functional capacity in the elderly, this information will be useful directing interventions at frail elderly, and assist in planning clinical trials to prevent or ameliorate the consequences of delirium in hospitalized patients.