OUTCOMES OF DELIRIUM IN THE ELDERLY

老年人谵妄的后果

• 批准号: 6691016
• 负责人: MARQUIS D FOREMAN
• 金额: $ 35.12万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6691016
• 关键词: anxiety; awareness; behavioral /social science research tag; clinical research; cognition disorders; delirium; functional ability; geriatrics; health care service utilization; human mortality; human old age (65+); human subject; longitudinal human study; outcomes research; patient oriented research

DESCRIPTION: (provided by the applicant) Delirium is a common disorder affecting as many as 80 percent of older hospitalized patients. Despite the fact that at least 30 percent of delirious patients continue to manifest symptoms at the time of discharge from the hospital, little investigation of delirium has occurred outside of acute care settings. The health outcomes directly attributable to delirium, the utilization of health care resources, the costs of care, the effects of continued care on delirium, and the actual course of delirium remain largely W1known. A prospective, longitudinal, cohort design with 10 years of follow-up is proposed; the work described here covers the first five years of study and reflects the first 3 years of follow-up. The specific aims are to: (1) evaluate the long-term effects of delirium on selected health outcomes, specifically, functional and cognitive status, mortality, utilization of health care resources, and the costs of care; (2) document the effect of continued care (e.g., institutionalization, rehabilitation, and home care) on the severity, duration, and recurrence of delirium; and (3) describe the natural course of delirium beyond an episode of hospitalization. Elderly subjects hospitalized for greater than 48 hours will be followed during their hospitalization. Eighty-six delirious subjects and 86 randomly selected non-delirious subjects will be followed at 1 week and 1, 2, 3, 6, 9, 12, 18, 24, 30, and 36 months after discharge. Major variables include cognition (Mini-Mental State Exam. Digit Span, modified Blessed Dementia Rating Scale), delirium (Confusion Assessment Method, NEECHAM Confusion Scale. Delirium Rating Scale), physical functional status (Activities of Daily Living, Instrumental Activities of Daily Living), resource utilization (Resource Utilization Inventory, continuing care, Readmission Inventory), and covariates (Charlson Index of Co-morbidity, Geriatric Depression Scale-Short Form). Data will be analyzed using descriptive statistics, repeated measures ANOV A and MANOV A, and survival analysis. Results of this study will establish a better understanding of the natural history of delirium, its long-term consequences, and the effects of continued care on delirium by which to design efficacious and cost-effective interventions to prevent or treat delirium.

描述：（申请人提供）del妄是一种常见疾病 影响多达80％的老年住院患者。尽管有 事实，至少有30％的妄想患者继续表现出来 出院时的症状，很少调查 在急性护理环境之外发生了ir妄。健康结果 直接归因于delirium，医疗资源的利用， 护理费用，持续护理对ir妄的影响以及实际 del妄的过程仍然在很大程度上已知。前瞻性，纵向的队列 提出了10年随访的设计；这里描述的工作涵盖 研究的前五年，反映了随访的前三年。这 具体目的是：（1）评估del妄的长期影响 选定的健康结果，特别是功能和认知状况， 死亡率，医疗资源的利用以及护理成本； （2） 记录持续护理的影响（例如制度化， 康复和家庭护理）关于严重性，持续时间和复发 谵妄; （3）描述妄想的自然过程超出了 住院。老年受试者住院48小时将 在住院期间被遵循。八十六个妄想和86个 随机选择的非轻率受试者将在1周和1、2中遵循 出院后的3、6、9、12、18、24、30和36个月。主要变量包括 认知（小精神状态考试，数字跨度，修改的祝福痴呆率评级 比例），del妄（混乱评估方法，NeeCham混乱量表。 ir妄评级量表），身体功能状态（日常生活的活动， 日常生活的工具活动），资源利用率（资源 利用清单，持续护理，再入院清单）和协变量 （查尔森（Charlson）共同多发性，老年抑郁量表缩小形式）。数据 将使用描述性统计数据分析，重复测量ANOV A和 Manov A和生存分析。这项研究的结果将建立更好的 了解del妄的自然历史，其长期后果， 以及持续护理对设计有效的ir妄的影响 以及具有成本效益的干预措施，以防止或治疗ir妄。