摘要
目的观察高龄老年住院患者谵妄的发生情况,对相关危险因素进行分析。方法选择2018年2月至2020年2月于徐州医科大学附属医院老年科住院的365例年龄≥80岁的患者为研究对象。应用老年综合评估(CGA)评估患者入院时情况,采用意识模糊评估表(CAM)评估患者入院后7 d内谵妄的发生情况,并将患者分为谵妄组(43例)和非谵妄组(322例)。采用SPSS 24.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。采用logistic回归分析谵妄发生的独立危险因素。结果365例老年患者中有43例发生谵妄,发生率为11.8%。谵妄组患者的居家环境、居住方式、多重用药率、抑郁症、营养不良发生率、多病共存发生率、衰弱状态、简易智能状态检查量表(MMSE)评分、老年综合征发生情况及入院时血清中枢神经特异蛋白100β(S100β)水平与非谵妄组相比,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄(OR=2.683,95%CI 1.005~4.019,P<0.05)、营养状况(OR=2.212,95%CI 1.101~5.212,P<0.05)、衰弱(OR=3.108,95%CI 1.005~5.015,P<0.05)、MMSE评分(OR=2.694,95%CI 0.705~3.117,P<0.05)、老年综合征数量(OR=1.412,95%CI 1.025~4.041,P<0.05)、S100β蛋白(OR=1.919,95%CI 1.789~4.664,P<0.05)是谵妄发生的独立危险因素。结论高龄老年住院患者谵妄发生率与营养状态、衰弱、认知功能障碍及S100β蛋白的升高相关,需要在临床上加以重视并及时干预。
Objective To observe the delirium of the elderly inpatients and analyze the related risk factors.Methods A total of 365 patients aged≥80 years were selected,who were admitted to the Geriatric Department of Affiliated Hospital of Xuzhou Medical University from February 2018 to February 2020.On admission the patients were assessed using the comprehensive geriatric assessment(CGA),and the incidence of delirium was assessed within 7 days after admission using the confusion assessment method(CAM).The patients were divided into delirium group(n=43)and non-delirium group(n=322)by CAM.SPSS statistics 24.0 was used for data analysis.Depending on the data type,t-test orχ^(2)test were used for comparison between groups.Logistic regression analysis was used to analyze the independent risk factors.Results Of 365 elderly patients,43 developed delirium with an incidence of 11.8%.The delirium group differed significantly from the non-delirium group in home environment,living style,polypharmacy rate,depression,malnutrition rate,coexistence rate,frail status,mini-mental state examination(MMSE)score,geriatric syndrome and serum central nervous system specific protein(S100β)level on admission(P<0.05).Multivariate logistic regression analysis showed that age(OR=2.683,95%CI 1.005-4.019;P<0.05),nutritional status(OR=2.212,95%CI 1.101-5.212;P<0.05),frailty(OR=3.108,95%CI 1.005-5.015;P<0.05),MMSE score(OR=2.694,95%CI 0.705-3.117;P<0.05),number of geriatric syndromes(1.412,95%CI 1.025-4.041;P<0.05),S100β(OR=1.919,95%CI 1.789-4.664;P<0.05)were all independent risk factors of delirium.Conclusion The incidence of delirium in the elderly inpatients is related to nutritional status,frailty,cognitive impairment and the increase of S100βprotein,which requires clinical attention and intervention.
作者
韩慧萍
郝敬波
陈梦楠
杨荣礼
卢海龙
HAN Hui-Ping;HAO Jing-Bo;CHEN Meng-Nan;YANG Rong-Li;LU Hai-Long(Department of Geriatrics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu Province,China)
出处
《中华老年多器官疾病杂志》
2022年第6期439-442,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
徐州市科技局资助课题(KC16SH078)。
关键词
谵妄
高龄老年
危险因素
delirium
advanced age
risk factors
