急性损伤,妄和危急疾病患者的结果之间的关联:系统性审查和元分析
Prit Kusirisin1,2, Angela Corsaro1, Janice Y Kung3
1Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, AB, Canada.
Critical care medicine
|December 17, 2025
概括
Delirium 在患有急性损伤 (AKI) 的危急病患者中很常见,影响了其中32%. 这种并发症与更糟糕的结果有关,包括较高的死亡率和医疗保健资源利用率的增加.
科学领域:
- 临界护理医学 临界护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
背景情况:
- 急性损伤 (AKI) 和妄是重症患者常见的并发症.
- 在这个人群中,AKI和妄之间的关系尚未得到充分证实.
- 现有证据需要综合来澄清关联.
研究的目的:
- 进行现有证据的系统综合和元分析.
- 为了澄清AKI与重症患者妄症之间的关联.
- 评估妄对AKI患者结局的影响.
主要方法:
- 从2000年1月到2025年1月,在多个数据库 (MEDLINE,Embase,CINAHL,Scopus,Web of Science,Cochrane Library) 中进行了全面的文献搜索.
- 包括18项观察性研究,涉及158,694名患者.
- 使用随机效应模型进行元分析,以总结比例,风险比率和加权平均差异;使用GRADE评估证据的确定性.
主要成果:
- 在AKI重症患者中,狂妄症的综合比例为32% (95%CI,18-47%).
- 在AKI患者中,狂妄症与显著增加的死亡率 (RR,2.36),增加的脏替代疗法使用 (RR,3.12),更长的ICU停留 (WMD,3.54天) 和更长的住院时间 (WMD,4.78天) 相关.
- 总体而言,研究质量中等.
结论:
- 痴呆症是AKI重病患者经常出现的并发症.
- 在AKI患者中妄的存在与不良结果有关,包括增加死亡率和资源利用率.
- 研究结果强调了识别和管理AKI患者的妄想的重要性.
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