在急诊室住院期间的过度活动妄想:风险因素的分析和与短期结果的关联
Òscar Miró1,2, Gina Osorio3, Aitor Alquézar-Arbé4
1Emergency Department, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain. omiro@clinic.cat.
Internal and emergency medicine
|October 21, 2023
概括
在急诊室 (ED) 经历狂妄症的老年患者与增加的医院死亡率有关. 诸如先前妄,阿片类药物使用和延长ED停留等因素预测其发展,需要预防策略.
科学领域:
- 老年医学 老年医学
- 紧急医疗 紧急医疗
- 精神病学是一个精神病学.
背景情况:
- 过度活动狂妄症是急诊室中老年患者的一个重大问题.
- 了解其风险因素和对短期结果的影响对于临床管理至关重要.
研究的目的:
- 在急诊室 (ED) 逗留期间,确定与老年人过敏 Delirium 发展相关的因素.
- 检查这种人群中过敏妄想和短期结果之间的关联.
主要方法:
- 多中心EDEN队列研究的二次分析.
- 包括65岁以上的患者提交ED,但不包括患有精神疾病,或内出血的患者.
- 狂妄症和非狂妄症组之间的34个变量进行比较,结果经过对共变量进行调整.
主要成果:
- 需要治疗的过度活动妄想发生在1.6%的患者中 (301/18,730).
- 独立预测因素包括先前的妄想发作,转移到观察,慢性阿片类药物治疗和ED停留时间>12小时. 慢性病显示出一个反向的关联.
- 在指数事件期间, Delirium 与住院死亡率 (16.4% vs 7.3%) 的增加有关.
结论:
- 以前的妄想,阿片类药物治疗和长时间的ED停留增加了老年ED患者过度活动妄想的风险.
- 预防措施对于减少妄想发病率和减轻不良结果,包括住院死亡率至关重要.
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