| 陶卫群,叶小英,任丽娜,谢新晖,邓海华,陈柏欣,李韵.精神专科医院危重症患者谵妄发生的危险因素：一项回顾性研究[J].四川精神卫生杂志,2023,36(3):242-247.Tao Weiqun,Ye Xiaoying,Ren Li'na,Xie Xinhui,Deng Haihua,Chen Baixin,Li Yun,Analysis of risk factors for delirium in critically ill patients in a psychiatric hospital： a retrospective study[J].SICHUAN MENTAL HEALTH,2023,36(3):242-247 |
| 精神专科医院危重症患者谵妄发生的危险因素：一项回顾性研究 |
| Analysis of risk factors for delirium in critically ill patients in a psychiatric hospital： a retrospective study |
| 投稿时间：2023-02-17 |
| DOI：10.11886/scjsws202320230217002 |
| 中文关键词: 精神专科医院 危重症患者 谵妄 危险因素 回顾性研究 |
| 英文关键词:Psychiatric hospital Critically ill patients Delirium Risk factors Retrospective study |
| 基金项目:广东省高水平临床重点专科（深圳市配套建设经费）资助（项目编号：SZGSP013） |
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| 中文摘要: |
| 背景 精神科危重症患者谵妄发生率较高，且影响谵妄发生的因素较多。目前针对精神专科医院危重症患者谵妄的流行病学研究有限。目的 探索精神专科医院危重症患者谵妄发生的影响因素，以指导临床对谵妄的管理。方法 回顾性收集2019年1月1日-2021年5月31日在深圳市康宁医院住院的427例危重症患者的谵妄发生情况、性别、年龄、入院前病程（指患者始发急性精神状态变化至登记入住精神专科医院的时间）、精神疾病史、认知功能障碍病史、精神活性物质使用史、镇静催眠药使用史、合并慢性病数、合并用药数以及病种类型等信息。采用单因素Logistic回归分析谵妄发生的可能危险因素，将可能的危险因素纳入多因素Logistic回归分析模型，逐步筛选出精神专科医院危重症患者谵妄发生的危险因素。结果 在427例危重症患者中，143例（33.49%）存在谵妄。多因素Logistic回归分析结果显示，使用精神活性物质所致的精神和行为障碍（OR=8.949，P<0.01）、无精神病病史（OR=4.202，P<0.01）、合并慢性病数（OR=1.249，P<0.01）、年龄（OR=1.031，P<0.01）以及入院前病程（OR=0.942，P<0.01）与谵妄发生相关。结论 在精神专科医院中，约1/3的危重症患者存在谵妄，入院前病程较短、年龄较大、合并慢性疾病数多、无精神疾病史、使用精神活性物质所致的精神和行为障碍是谵妄发生的危险因素。 |
| 英文摘要: |
| Background The incidence of delirium in critically ill psychiatric patients is high， and there are many factors affecting delirium occurrence. At present， epidemiological studies on delirium among critically ill patients in psychiatric hospitals are limited.Objective To explore the risk factors for delirium in critically ill patients in a psychiatric hospital， so as to guide the clinical management of delirium in psychiatric hospitals.Methods This retrospective study included 427 critically ill patients who were admitted to Shenzhen Kangning Hospital from January 1， 2019 to May 31， 2021. The delirium situation， gender， age， pre-admission course of illness （duration from the onset of acute mental state changes to in-patient registration at a psychiatric hospital）， history of mental illness， history of cognitive dysfunction， history of using psychoactive substances， history of using sedative and hypnotic drugs， number of combined chronic diseases， number of combined drugs and type of disease were examined as potential risk factors for delirium. Single Logistic regression was used to analyze the potential risk factors for delirium， and the potential risk factors were incorporated into the multi-factor Logistic regression analysis model so as to gradually screen out the risk factors for delirium in critically ill psychiatric patients.Results Delirium was present in 33.49% （143/427） of critically ill patients. Multi-factor Logistic regression analysis demonstrated that the presence of delirium was associated with mental and behavioral disorders caused by psychoactive substances （OR=8.949， P<0.01）， absent history of mental illness （OR=4.202， P<0.01）， number of combined chronic diseases （OR=1.249， P<0.01）， age （OR=1.031， P<0.01） and pre-admission course of illness （OR=0.942， P<0.01） .Conclusion Delirium was present in nearly 1/3 critically ill patients in the psychiatric hospital. The risk factors for delirium included short course of illness before admission， age， more combined chronic diseases， absent history of mental illness， mental and behavioral disorders caused by psychoactive substances. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）］ |
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