Crit Care:重症监护室患者谵妄与神经精神疾病之间的关联

2020-08-02 MedSci原创 MedSci原创

ICU患者新的神经认知障碍诊断与谵妄有关。在这项研究中,没有观察到谵妄与抑郁症、焦虑症以及创伤和应激相关疾病之间显著的相关性。

重症监护病房(ICU)的患者发生谵妄的风险增加,但尚不清楚随后发生神经精神疾病的风险。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员旨在评估ICU成年患者入住ICU后谵妄与神经精神疾病(包括抑郁症、焦虑症、与创伤和应激相关的疾病以及神经认知障碍)之间的关联。

该回顾性队列研究利用住院患者和门诊患者就诊的临床和行政数据来确定ICU住院前5年和住院后1年的ICU队列和诊断信息。该研究纳入了2014年1月1日至2016年6月30日期间在加拿大艾伯塔省14个外科ICU其中一个ICU内接受手术且存活至出院的18岁以上患者。感兴趣的主要结局是ICU住院后1年的任何神经精神疾病。

在16005名ICU患者中,有4033名患者被纳入研究,其中1792名(44%)在其入住ICU时出现谵妄。第二年,ICU患者的任何神经精神疾病的总体累积发生率为19.7%。使用对数二项式回归对医院特征进行调整后,相比那些没有发生谵妄的ICU患者,发生谵妄的ICU患者在出院后1年内发生神经精神疾病的风险比(RR)为1.14(95%置信区间[CI]为0.98–1.33)。谵妄与神经认知障碍(RR为1.59,95%CI为1.08–2.35)显著相关,但与抑郁症(RR为1.16,95%CI为0.92–1.45)、焦虑症(RR为1.16,95%CI为0.92-1.47)和创伤与应激相关的疾病(RR为0.82,95%CI为0.53-1.28)无关。

由此可见,ICU患者新的神经认知障碍诊断与谵妄有关。在这项研究中,没有观察到谵妄与抑郁症、焦虑症以及创伤和应激相关疾病之间显著的相关性。

原始出处:

Kyla N. Brown.et al.Association between delirium in the intensive care unit and subsequent neuropsychiatric disorders.Critical Care.2020.https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03193-x

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    2020-08-04 bioon6
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    2020-08-02 wxl882001

    了解一下

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    2020-08-02 ms1000000465791691

    学习了

    1

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    2020-08-02 superykr

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