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Necesidades de cuidados de pacientes con cribado positivo para deterioro cognitivo y delirium: un estudio

Alison M Mudge^1,2, Sarah Anderson³, Aparna Arjunan³

¹Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

Journal of advanced nursing

|March 6, 2026

Aim:

Para describir la prevalencia puntual del deterioro cognitivo en adultos hospitalizados y evaluar la asociación con las necesidades de cuidados y los riesgos percibidos de complicaciones.

DiseñO:

Estudio transversal multisitio realizado en un único día de mayo de 2023.

MéTodos:

Auditores clínicos capacitados evaluaron la presencia de deterioro cognitivo mediante el 4AT en pacientes adultos ingresados en salas de medicina aguda, cirugía, oncología, geriatría, salud mental, convalecencia y rehabilitación en siete centros sanitarios, y registraron la necesidad de apoyo en las actividades básicas de la vida diaria, la incontinencia y los riesgos percibidos de complicaciones (caídas, lesiones por presión y desnutrición). Los datos se resumieron y compararon entre las categorías del 4AT, y la fuerza de la asociación entre el 4AT y cada resultado se estimó mediante modelos de regresión multivariable.

Resultados:

Se dispuso de datos de 1145 pacientes hospitalizados en 68 salas (edad media 68 años [DE = 18], 583 [58,9%] mujeres, 449 [39,2%] en unidades médicas agudas). Se identificó deterioro cognitivo (4AT de 1 o más) en 482 (42,1%) participantes. Los participantes con un 4AT de 1-3 presentaron probabilidades entre 2,0 y 3,6 veces mayores de requerir supervisión o asistencia en las actividades de la vida diaria, mientras que aquellos con un 4AT de 4 o más presentaron probabilidades entre 2,9 y 5,3 veces mayores de requerir asistencia.

ConclusióN:

El deterioro cognitivo es muy frecuente en los pacientes adultos hospitalizados y se asocia con necesidades de cuidados físicos significativamente mayores.

Implicaciones Para La ProfesióN Y La AtencióN Al Paciente:

Los modelos de atención hospitalaria deben brindar apoyo al personal para abordar las mayores necesidades de cuidado de las personas con deterioro cognitivo, con el fin de proteger a un grupo amplio de pacientes de los daños adquiridos en el hospital.

ContribucióN Del Paciente O Del PúBlico:

Sin contribución de pacientes ni del público.

Reporting Method:

Este estudio se ajusta a las guías de notificación STROBE.

Palabras clave:

disfunción cognitiva delirium demencia hospitalización cuidados de enfermería

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