合并视力障碍的老年内科住院病人谵妄发生率及影响因素

Analysis of incidence and risk factors of delirium in hospitalized elderly medical patients with visual impairment

目的了解视力障碍的老年内科疾病病人住院期间谵妄发生率和相关影响因素。方法采用前瞻性队列研究方法,入选2016年3月至2017年1月四川大学华西医院老年科存在视力障碍的老年住院病人。入院48 h内对病人进行视力检查和谵妄相关危险因素评估,从住院当天至住院第13天每隔一天对病人进行谵妄评估,记录住院期间有无发生谵妄,并分析谵妄的危险因素。结果共纳入243例存在视力障碍的老年住院病人,其中53例(21.8%)发生谵妄。多因素Logistic回归分析显示,年龄、重度合并症指数、认知功能受损是内科视力障碍老年住院病人发生谵妄的独立危险因素。结论要积极预防高龄、合并多种疾病和存在认知功能障碍的老年视力障碍病人谵妄的发生。

Objective To learn the incidence and risk factors of delirium in hospitalized elderly medical patients with visual impairment.Methods In this prospective cochort study,elderly patients with visual impairment admitted to the Geriatrics Department of West China Hospital of Sichuan University from March 2016 to January 2017 were included.Visual acuity and risk factors of delirium were assessed within 48 h after admission.Delirium screening was performed within 48 h of admission and every 48 h thereafter until discharge or for a maximum of 13 days.Results A total of 243 elderly inpatients with visual impairment were included,of whom 53(21.8%)developed delirium.Multivariate Logistic regression analysis showed that age,severe comorbidity index,and cognitive impairment were independent risk factors for delirium.Conclusions We should actively prevent the development of delirium for hospitalized elderly patients with visual impairment,especially for those with advanced age,severe comorbidities and cognitive impairment.