摘要
目的探讨年龄、谵妄诱因、痴呆、谵妄严重程度及疾病严重程度等因素与老年性谵妄患者预后的相关性。方法纳入我院2013年1月至2015年12月住院期间首次发生谵妄的70岁及以上老年患者112例,谵妄确诊后应用谵妄评定量表修订版(DRS-R)-98评分进行谵妄严重程度分级,并记录患者发生谵妄48h内急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及序贯器官功能衰竭评分(SOFA)。对患者随访至2017年12月31日。统计分析年龄、谵妄诱因、痴呆等因素与谵妄发生后患者生存期、生活能力的相关性。结果年龄、诱发因素、既往有无认知障碍、既往认知障碍年限、痴呆类型和谵妄严重程度均与患者发生谵妄后的生存期及生活能力差异无统计学意义,而疾病严重程度APACHEⅡ评分(r=-0.390,P<0.001)和SOFA评分(r=-0.638,P<0.001)与患者的生存期呈负相关。SOFA评分(P=0.004)和谵妄复发情况(P<0.001)与远期生活能力相关。结论疾病严重程度、谵妄复发情况与谵妄发生后患者生存期及生存质量相关,相对于APACHEⅡ评分,SOFA评分在预测老年谵妄预后可能更有临床应用价值。
ObjectiveTo investigate the correlations of risk factors of age, delirium-inducing factors, dementia, delirium severity, and disease severity with the prognosis of elderly patients with delirium. MethodsA total of 112 patients aged 70 years and older with initial onset of delirium during hospital stay were enrolled in this study.They were hospitalized in Dalian Municipal Central Hospital from Jan.2013 to Dec.2015.The severity of delirium was evaluated by delirium rating scale-revised-98(DRS-R-98). The acute physiology and chronic health enquiry(APACHE-Ⅱ)score and the sequential organ failure assessment(SOFA)score were recorded within 48 h after delirium onset.After periods of hospitalization of Jan.2013 to Dec.2015, patients were followed up until 31 Dec 2017.Correlations of age, delirium-inducing factors and dementia with survival time and long-term viability after delirium onset were statistically analyzed. ResultsAge, delirium-inducing factors, cognitive impairment, duration of cognitive impairment, type of dementia, and delirium severity had no correlations with the lifetime and long-term viability in patients with delirium.While, APACHE Ⅱ score for assessment of severity degree of delirium(P<0.001, r=-0.390)and SOFA score(P<0.001, r=-0.638)were negatively correlated with the lifetime in patients with delirium.SOFA score(P=0.004)and delirium recurrence(P<0.001)were significantly correlated with the long-term viability in patients with delirium. ConclusionsThe severity and recurrence of delirium are strongly correlated with the lifetime and quality of life in patients with delirium.Compared with APACHE Ⅱ score, SOFA score may have a more important clinical application value in predicting the prognosis of patients with delirium.
作者
刘思伯
刘赞华
王虹
赵红岭
隋晓雯
张琳
张美艳
马笑
李颖
丁旭
刘金洁
Liu Sibo;Liu Zanhua;Wang Hong;Zhao Hongling;Sui Xiaowen;Zhang Lin;Zhang Meiyan;Ma Xiao;Li Ying;Ding Xu;Liu Jinjie(Surgery Intensive Care Unit, Dalian Municipal Central Hospital, Dalian 116033, China;Department of Neurology, Dalian Municipal Central Hospital, Dalian 116033 China;Department of Neurology, Dalian Municipal Central Hospital, Dalian 116033 China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2019年第2期161-164,共4页
Chinese Journal of Geriatrics
关键词
谵妄
预后
Delirium
Prognosis
