在老年人中,由于潜在的可避免住院病例引起的妄想
Caroline Whittington1, Rachel M Skains2, Yue Zhang3
1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
概括
Delirium 在住院的老年人中很常见. 虽然在门诊护理敏感疾病 (ACSCs) 中不太频繁,但病例率仍然很高,这凸显了需要更好的门诊护理来预防医院并发症的必要性.
科学领域:
- 老年病的医生 老年病的医生
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 狂妄症是老年人急性护理住院期间经常出现的并发症.
- 门诊护理敏感条件 (ACSCs) 占潜在可避免住院治疗的很大一部分.
- 对ACSC的早期门诊治疗可以预防住院和相关并发症,如妄想.
研究的目的:
- 调查因门诊护理敏感疾病 (ACSCs) 住院的老年人 Delirium 的发生率.
- 为了在老年人中比较ACSC入院和非ACSC入院之间的妄想率.
- 在这个患者群体中确定 Delirium 的预测因素.
主要方法:
- 在2015-2019年期间接受治疗的39933名老年人 (≥65岁) 的回顾性横截面研究.
- 使用护理狂妄查量表或重症监护病房混乱评估方法评估狂妄症.
- 一般化的线性混合模型用于分析ACSC和妄之间的关联,调整共变量.
主要成果:
- 痴呆症发生在所有老年成人入院病例的15.6%.
- 与非ACSC录取 (15.8%) 相比,ACSC录取 (13.9%) 的 Delirium 率较低.
- 高龄和更高的并发症是 Delirium 发展的显著预测因素.
结论:
- 由于ACSC住院的老年人中 Delirium 的发作率虽然低于其他疾病,但仍然很高.
- 改善ACSCs的门诊管理对于减少住院和医院相关并发症,如妄想,至关重要.
- 对具有较高并发症的老年人进行有针对性的干预可以减轻妄想风险.
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