OUTCOMES OF DELIRIUM IN HOSPITALIZED ELDERLY

谵妄可能是急性内科疾病的并发症， 30%的住院老人。 然而，很少有研究涉及 它的流行病学，危险因素，或自然史与严格的（ 标准，统一的情况下查明，并注意到潜在的 混杂因素。 我们假设精神错乱的发生 确定了一组体弱长者与稳态损伤， 可能会被临床识别 这样的患者很可能 长期死亡、认知能力下降、 和功能障碍。 这项研究将检查发病率，患病率和长期 社区老年人谵妄的预后 大学医院普通内科病房。 行为 谵妄指标将通过筛选所有符合条件的 每48小时一次的入院时间足以让他们住院。 的 将通过以下方式确定是否存在DSM-III-R谵妄标准： 并由老年心理医生独立确认。 谵妄与潜在风险因素的关系，如年龄， 性别、社会支持、身体功能、疾病严重程度和急性 和慢性疾病将被检查。 为 在本研究的纵向阶段，将组装两个队列- 一个是谵妄病例，另一个是对照组， 年龄、性别和入院类型（急诊或择期）-两者 每6个月对各组进行一次随访，共随访2年 为了确定长期死亡率的差异， 制度化，以及功能和认知下降。 生存分析我们研究了谵妄与长期- 长期结果，控制已知影响这些结果的变量 结果。 如果谵妄是一个独立的风险因素， 在老年人的功能能力，这将是有益的信息 指导对体弱老人的干预，并协助规划 临床试验，以预防或改善的后果 住院病人的谵妄。

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.