妄想中限制治疗的决定:对前性观察研究的二次分析
Victor Montaut1, Louise Bergqvist1, Hervé Zender2,3,4
1Department of Internal Medicine, Neuchâtel Hospital Network, Rue de la Maladière 45, Neuchâtel, CH-2000, Switzerland.
BMC medical ethics
|December 17, 2025
概括
患有妄想症的住院患者经常会收到治疗限制决定 (TLD). 然而,当考虑患者的并发症时,这种关联会减弱,尽管狂妄症和TLD命令都预测90天的再入院或死亡.
科学领域:
- 老年医学 老年医学
- 内部医学 内部医学
- 关键的护理关键的护理
背景情况:
- 治疗限制决定 (TLD) 是复杂的,受到伴随性疾病和文化因素的影响.
- 痴呆症是住院患者常见的并发症,影响临床结果.
- 妄想和TLD之间的关系需要进一步调查.
研究的目的:
- 为了比较患有 Delirium 和没有 Delirium 的患者之间的 TLD 订单率.
- 为了确定与TLD订单相关的因素.
- 探索TLD和痴呆症对90天死亡率或再入院的综合影响.
主要方法:
- 一组内科患者在入院48小时内接受了正式的妄想评估.
- 系统地记录了TLD订单,90天死亡率和再入院的数据.
- 进行了统计分析,以评估关联并为混因素进行调整.
主要成果:
- 超过一半的患者至少有一个TLD命令 (例如",不要复苏"",不要输管").
- 狂妄症最初与TLD订单的可能性更高 (77.4%与51.1%) 相关,但经过对伴随性疾病进行调整后,这一意义下降了.
- 无论是TLD订单还是妄想,都独立地预测了90天再入院或死亡的风险更高.
结论:
- Delirium 在患有 TLD 订单的患者中很常见,但直接关联被伴随性疾病所混.
- 狂妄和TLD订单是独立的风险因素,可能导致在释放后90天内出现不良结果.
- 早期的妄想评估对于了解患者护理轨迹和结果至关重要.
更多相关视频
07:42Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
3.6K
07:26Characterizing the Relationship Between Eye Movement Parameters and Cognitive Functions in Non-demented Parkinson's Disease Patients with Eye Tracking
Published on: September 26, 2019
8.2K
相关概念视频
Alzheimer's Disease: Treatment
752
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
752
Psychosis: Goals of Pharmacotherapy
441
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
441
Observational Studies
10.7K
Observational studies are a type of analytical study where researchers observe events without any interventions. In other words, the researcher does not influence the response variable or the experiment's outcome.
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
10.7K
Therapeutic Drug Monitoring: Affecting Factors
175
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
175
