痴呆症的严重程度和重症COVID-19患者的结果
Luciana Leal do Rego1, Jorge Ibrain Figueira Salluh2, Vicente Cés de Souza-Dantas2
1Postgraduate Program in Clinical Medicine, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.
Critical care science
|January 24, 2024
概括
重症COVID-19患者的痴呆症显著恶化了结果,增加了ICU停留,医院死亡率和一年死亡率. 用CAM-ICU-7测量的妄想严重程度,预测预后较差,包括昏迷和机械通风.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 神经学 神经学
背景情况:
- 痴呆症是重症患者常见的并发症.
- 在重症监护机构中,COVID-19带来了独特的挑战.
- 了解妄想的影响对于改善患者的治疗结果至关重要.
研究的目的:
- 评估痴呆症严重程度对重症COVID-19患者的影响.
- 为了确定 Delirium 和患者的结果,包括死亡率之间的关联.
- 为了研究痴呆症严重程度评分对不良事件的预测值.
主要方法:
- 在两个三级重症监护病房进行前性队列研究.
- 在前7天使用里士满兴奋镇静量表,CAM-ICU和CAM-ICU-7进行每日狂妄的评估.
- Delirium 严重程度与 ICU 停留时间,医院死亡率和一年死亡率的相关性.
主要成果:
- 在277名COVID-19患者中,狂妄症发生在36.5%的人中.
- Delirium 与更长的ICU停留 (13 vs. 6天),更高的医院死亡率 (25.74% vs. 5.11%) 和增加的一年死亡率 (5.3% vs. 0.6%) 相关.
- 较高的CAM-ICU-7得分与增加的住院死亡率和更大的昏迷和机械呼吸系统进展风险相关.
结论:
- 痴呆症是COVID-19ICU患者预后不佳的独立风险因素.
- 由CAM-ICU-7评估的妄想严重程度,预测了诸如昏迷和机械呼吸等不良结果.
- 对重症COVID-19患者来说,早期发现和治疗妄症至关重要.
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