实验室检测的诊断产量在住院的老年人与改变精神状态的精神状态
Kamber L Hart1, Kathleen M McFadden1, Sara B Golas2
1Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States.
General hospital psychiatry
|April 16, 2025
概括
在老年人中,常规实验室测试改变精神状态 (AMS) 显示出多种有用性. 虽然像TSH这样的常见测试的产量很低,但像这样的较少测试的异常更常见,指导了一些治疗方法.
科学领域:
- 老年病的医生 老年病的医生
- 临床诊断 临床诊断 临床诊断
- 内部医学 内部医学
背景情况:
- 改变精神状态 (AMS) 是老年人住院的常见原因之一.
- 常规实验室检测AMS的诊断和治疗价值尚未得到充分证实.
研究的目的:
- 评估在老年人AMS工作中使用的常见实验室测试的诊断和治疗效用.
- 为了确定测试的频率,异常结果,以及在这个患者群体中进行特定实验室测试的后续治疗.
主要方法:
- 对于65岁及以上患者的AMS住院患者入院的回顾性队列研究 (2017-2022年).
- 评估了TSH,梅毒,维生素B12,C,D,叶酸,,尼亚和胺的实验室测试.
- 计算了测试频率,异常率和治疗后续情况.
主要成果:
- 在3169名患者中,73%的患者进行了至少一次测试;所有测试中有12%的异常.
- 常见的测试 (TSH,叶酸,B12) 具有较低的诊断/治疗效用.
- 不太常见的测试 (,维生素C和维生素D) 更频繁地出现异常.
- 16%的异常结果导致了新的处方;72%的异常梅毒测试导致了青素治疗.
结论:
- 老年人中AMS的常规实验室测试具有可变的诊断和治疗效用.
- 需要进一步的研究,以了解实验室异常对AMS的贡献,并优化高价值护理.
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