重症监护病房术后谵妄症状与患者预后之间的关系

Amany ElshrabasyAbd- Elghaffar, Tahany Ahmed El-Senousy, Asmaa Abd El rahman Abd El Rahman, Amira Hedaya Mourad
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摘要

背景:术后谵妄是一种神经认知并发症,其不良后果可能远远超出手术恢复的范围。术后谵妄与术后恢复延迟、费用增加、发病率和死亡率上升有关。研究目的:本研究旨在评估重症监护病房术后谵妄症状与患者预后之间的关系。研究设计:采用描述性探索研究设计来实现本研究的目的。研究环境:本研究在艾因夏姆斯大学附属医院 El-Demerdash 医院的重症监护室进行。研究对象:本研究有目的性地抽取了 325 名入住重症监护室的术后患者。数据收集工具:(1)患者评估问卷;(2)里士满躁动-镇静量表;(3)重症监护室谵妄筛查清单;(4)结果评估问卷。结果本次研究结果显示,73.3%的谵妄患者在重症监护室停留了5-10天,43.4%的患者意外拔除了静脉管路,28.9%的患者拔除了中心管路。谵妄类型与患者认知功能障碍之间存在统计学关系,P 值小于 0.05。结论研究对象的谵妄症状包括意识水平、注意力、定向力和幻觉的改变。此外,还有精神运动性躁动/迟缓、睡眠/觉醒周期紊乱和情绪/言语不当。研究结果还表明,谵妄类型与患者再次入住重症监护室、中风、急性肾损伤和重症监护室死亡率之间没有关系。建议应评估重症监护室患者的谵妄症状,以便及早处理,防止进一步的并发症,改善患者的预后。
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Relation between Delirium Symptoms and Patients’ Outcomes during the Postoperative Period in Intensive Care Units
Background: Postoperative delirium is a neurocognitive complication with adverse consequences that may extend far beyond surgical recovery. Postoperative delirium is associated with a delay in postoperative recovery, increased costs, and increased morbidity and mortality. Aim: This study aimed to assess the relation between delirium symptoms and patients’ outcomes during the postoperative period in intensive care units. Study design: A descriptive exploratory research design was utilized to achieve the aim of this study. Setting: This study was conducted in the intensive care unit at El-Demerdash hospital which affiliated to Ain Shams University hospitals. Subjects: Purposeful samples of 325 postoperative patients admitted to the intensive care unit were included in this study. Tools of data collection: (1) Patients' assessment questionnaire, (2) Richmond agitation-sedation scale, (3) Intensive care delirium screening checklist, (4) Outcomes assessment questionnaire. Results: The result of the current study showed that 73.3% of delirious patients had stayed in the ICU from 5-10 days, 43.4% remove intravenous lines accidently, 28.9% removed central line. There was a statistical relation between type of delirium and the studied patients’ cognitive dysfunction p-value < 0.05. Conclusion: Delirium symptoms among the studied patients were altered patients’ level of consciousness, attention, orientation and hallucinations. In addition to, psychomotor agitation / retardation, sleep/wake cycle disturbance and inappropriate mood/speech. As well, the results illustrated that there was no relation between delirium type and patients’ readmission to the ICU, stroke, acute kidney injury and ICU mortality. Recommendations: Patients in the intensive care units should be assessed for delirium symptoms for early management and to prevent further complications and improve patients’ outcomes.
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