穿皮冠状动脉干预后老年人 Delirium:流行率,风险和临床表型
Dae Yong Park1, Yasser Jamil2, Jiun-Ruey Hu3
1Department of Medicine, Cook County Health, Chicago, IL, USA.
概括
在接受皮肤冠状动脉干预 (PCI) 的老年人中 Delirium 是常见的,并增加死亡风险. 早期识别和预防对于更好的患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 关键护理医学 关键护理医学
背景情况:
- 在老年人中,住院妄想很普遍,与增加的死亡率和不良结果有关.
- 接受皮肤穿冠状动脉干预 (PCI) 的老年人代表了 Delirium 发展的脆弱人群.
研究的目的:
- 确定接受PCI的老年人 (≥75岁) Delirium 的当代患病率.
- 评估住院妄想对这一患者群的死亡率和并发症的影响.
主要方法:
- 对接受住院PCI的75岁以上患者的国家住院样本 (2016-2020年) 的分析.
- 将患者分为有 Delirium 和没有 Delirium 的患者,并比较住院死亡率和术后并发症.
主要成果:
- 痴呆症发生在2.6%的PCI住院患者中;痴呆症患者年龄较大,并患有更多的并发症.
- 住院妄显著增加了死亡率 (aOR 1.27) 和非家庭出院 (aOR 3.17) 的几率.
- 狂妄症与内出血,胃肠道出血,输血,急性损伤和跌倒的可能性更高.
结论:
- 狂妄症是接受PCI的老年人常见的并发症,与增加的死亡率和不良事件有关.
- 在接受PCI的老年患者的外科护理中,警预防和早期识别是必不可少的.
相关概念视频
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
21
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
21
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
17
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
17
Coronary Artery Disease III: Clinical Manifestations
13
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
13
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Acute Coronary Syndrome I: Introduction
32
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
32
Acute Coronary Syndrome V: Nursing Management
17
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
17


