神经内科重症患者谵妄的危险因素及CAM-ICU与ICDSC量表的早期筛查评估

Risk Factors of Delirium in Critically Patients in Neurology Department and Early Screening Evaluation of CAM-ICU and ICDSC Scale

目的探讨神经内科重症患者谵妄的危险因素及ICU意识模糊评估法(CAM-ICU)、重症监护谵妄筛查量表(ICDSC)的评估效能。方法选取2020年1月至2021年6月于我院神经内科住院重症患者113例。记录研究对象的基本资料,并分为非谵妄组和谵妄组。用多元Logistic回归模型分析谵妄危险因素,采用CAM-ICU、ICDSC量表对患者进行谵妄评估。结果113例患者中发生谵妄40例,占35.40%。两组年龄、酗酒史、合并疾病、住院时间、镇静药物使用情况比较有统计学意义(P<0.05)。年龄、酗酒史、镇静药物使用情况均是影响神经内科住院重症患者谵妄的独立因素(P<0.05)。CAM-ICU联合ICDSC评估谵妄的敏感度、特异度均高于CAM-ICU、ICDSC。结论年龄、酗酒史、镇静药物使用情况均是影响神经内科住院重症患者谵妄的独立因素,同时建议联合使用CAM-ICU和ICDSC对患者进行谵妄筛查。

Objective To investigate the risk factors of delirium in critically ill patients in the Department of Neurology and the evaluation efficacy of the ICU Confusion Assessment Method(CAM-ICU)and the Intensive Care Delirium Screening Scale(ICDSC).Methods A total of 113 critically ill patients who were hospitalized in the Department of Neurology of the First People’s Hospital of Shangqiu City from January 2020 to June 2021 were selected.Results The basic information of the research subjects and divide them into non-delirium group and delirium group.Multivariate Logistic regression model was used to analyze the risk factors of delirium,and the CAM-ICU and ICDSC scales were used to evaluate patients with delirium.Results 40 cases of delirium occurred in 113 patients,accounting for 35.40%.There were statistically significant comparisons between the two groups in terms of age,history of alcoholism,comorbid diseases,length of hospitalization,and use of sedative drugs(P<0.05).Age,history of alcohol abuse,and use of sedative drugs are all independent factors affecting delirium in critically ill patients in the Department of Neurology(P<0.05).The sensitivity and specificity of CAM-ICU combined with ICDSC in evaluating delirium are higher than those of CAM-ICU and ICDSC.Conclusion Age,history of alcohol abuse,and sedative use are all independent factors that affect delirium in critically ill patients in the Department of Neurology.At the same time,it is recommended to use CAM-ICU and ICDSC to screen patients for delirium.