Stroke:急性卒中患者谵妄的发生率

2019-09-27 xing.T MedSci原创

由此可见,谵妄很常见,影响大约四分之一的急性卒中患者。报告的谵妄发生率可能取决于评估方法。研究人员对谵妄发生的估计可用于审核、计划干预研究并为临床实践提供参考。

谵妄与严重疾病后的死亡率增加,住院时间延长和功能结局不良有关。中风谵妄的流行病学资料并不全面。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员试图收集有关急性卒中患者谵妄发生(发生率或患病率)的证据。

研究人员使用预先指定的检索策略,通过人工检索了多个跨学科的电子数据库。符合条件的研究描述了急性(前6周)卒中谵妄的发生情况。研究人员使用随机效应模型比较了谵妄的发生率,以描述汇总估算值。研究人员使用纽卡斯尔-渥太华工具评估了偏倚风险,并将其纳入敏感性分析。研究人员对谵妄诊断方法(混乱评估方法评分、临床诊断等),谵妄评估的持续时间和时机(>1或<1周)进行了亚组分析,并根据发布年份进行了荟萃回归。

从8822篇文献中,研究人员定量分析了32篇文献(6718名参与者)。谵妄发生的汇总估计为25%(95%CI为20%–30%;中等质量的证据)。限于低偏倚风险的研究(22个研究,4422名参与者),发生率为23%(95%CI为17%–28%)。亚组汇总估计表明谵妄的发生可能随评估方法的不同而有所不同:混乱评估方法为21%(95%CI为16%–27%);临床诊断为27%(95%CI为19%–38%);其他为32%(95%CI为22%–43%)。Meta回归提示,与历史研究和最新研究相比,谵妄的发生率有所下降(斜率为0.03 [SE为0.004];P<0.0001)。

由此可见,谵妄很常见,影响大约四分之一的急性卒中患者。报告的谵妄发生率可能取决于评估方法。研究人员对谵妄发生的估计可用于审核、计划干预研究并为临床实践提供参考。 

原始出处:

Robert C. Shaw.et al.Occurrence Rate of Delirium in Acute Stroke Settings Systematic Review and Meta-Analysis.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025015

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    2021-01-09 thrase

    希望能进一步研究卒中相关谵妄的特异性治疗

    0

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    2019-09-27 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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