UNASSIGNED: To determine the risk factors of delirium in elderly inpatients in a nonintensive care unit setting.
UNASSIGNED: Sixty two elderly patients with delirium (cases) and 62 patients without delirium (controls) were administered a semi-structured proforma with socio-demographic variables and putative predisposing and precipitating risk factors and the Vellore screening instrument for dementia.
UNASSIGNED: On univariate analysis, factors such as past cognitive impairment, history of nocturnal confusion and delirium, diminished daily living activities, severe medical illness, history of psychiatric illness, presence of dementia, infection, fever above 1000F, abnormal electrolytes abnormal RFT, leukocytes in urine, hypoxia, anticholinergics and benzodiazepines, emergency admission, use of physical restraints, bladder catheterization, more than routine investigations, intensive care unit admission, surgery, and duration of hospital stay more than 10 days were found to be significantly associated with delirium. On multivariate analysis with binary logistic regression, bladder catheterization (odds ratio [OR] = 13.85; confidence interval [CI] = 1.44-133.14), abnormal electrolytes (OR = 5.12; CI = 1.11-23.69), and hypoxia (OR = 75.52; CI = 4.64-1.134E3) were detected to be independently associated with delirium.
UNASSIGNED: Acute modifiable rather than long-term factors were risk factors for delirium among the elderly. An awareness of modifiable risk factors has the potential of developing targeted interventions for the early mitigation of delirium.
■确定非重症监护病房老年住院患者谵妄的危险因素。
■62例有谵妄的老年患者(病例)和62例无谵妄的患者(对照)接受了具有社会人口统计学变量和推定的诱发性和诱发性危险因素的半结构性形式检查,以及Vellore筛查工具。
■关于单变量分析,因素,如过去的认知障碍,夜间意识错乱和谵妄的历史,日常生活活动减少,严重的医疗疾病,精神病病史,痴呆症的存在,感染,1000F以上的发烧,电解质异常,RFT异常,尿液中的白细胞,缺氧,抗胆碱能药和苯二氮卓类药物,紧急入院,使用身体约束,膀胱导管插入术,不仅仅是常规调查,重症监护室入院,手术,发现住院时间超过10天与谵妄显著相关。在二元逻辑回归的多变量分析中,膀胱导管插入术(比值比[OR]=13.85;置信区间[CI]=1.44-133.14),电解质异常(OR=5.12;CI=1.11-23.69),缺氧(OR=75.52;CI=4.64-1.134E3)与谵妄独立相关。
■急性可改变而非长期因素是老年人谵妄的危险因素。对可改变的危险因素的认识有可能制定有针对性的干预措施,以早期缓解谵妄。