DELIRIUM AND OTHER COGNITIVE IMPAIRMENT IN OLDER ADULTS IN AN EMERGENCY DEPARTMENT

被引：127

作者：

NAUGHTON, BJ ^{[1
]}

MORAN, MB ^{[1
]}

KADAH, H ^{[1
]}

HEMANACKAH, Y ^{[1
]}

LONGANO, J ^{[1
]}

机构：

[1] NORTHWESTERN UNIV,SCH MED,DEPT MED,DIV GERIATR,CHICAGO,IL 60611

来源：

ANNALS OF EMERGENCY MEDICINE | 1995年 / 25卷 / 06期

关键词：

D O I：

10.1016/S0196-0644(95)70202-4

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To determine the prevalence of delirium and other alterations in mental status in older adults in the emergency department setting. Design: Prospective, cross-sectional study. Setting: Private, nonprofit, academic medical center in a densely populated urban area. Participants: One hundred eighty-eight adults 70 years or older who presented to the ED. Interventions: None. Results: Delirium and other alterations in mental status were present in 39.9% of the patients studied; 24% of these patients had delirium. Age and severity of illness were positively correlated with alteration in mental status. Patients with alterations in mental status were more likely to be admitted to an inpatient unit. Among those admitted from home, alterations in mental status in the ED were associated with a higher likelihood of institutionalization at discharge. Conclusion: Alterations in mental status are prevalent in ED patients. Older adults with alterations in mental status, particularly alterations in consciousness and delirium, are at high risk for admission to an inpatient unit and institutionalization after discharge. Standardized mental status testing identified highrisk older adults in the ED.

引用

页码：751 / 755

页数：5

共 18 条

[1]

Strange, Chen, Sanders, Use of emergency departments by elderly patients: Projections from a multicenter data base, Ann Emerg Med, 21, pp. 819-824, (1992)

[2]

Baum, Rubenstein, Old people in the emergency room: Age-related differences in emergency department use and care, J Am Geriatr Soc, 35, pp. 398-404, (1987)

[3]

Ettinger, Casani, Coon, Et al., Patterns of use of the emergency department by elderly patients, J Gerontol, 42, pp. 638-642, (1987)

[4]

Stern, Weissman, Epstein, The emergency department as a pathway to admission for poor and high-cost patients, JAMA, 266, pp. 2238-2243, (1991)

[5]

Teasdale, Jennett, Assessment of coma and impaired consciousness: A practical scale, Lancet, 2, pp. 81-84, (1974)

[6]

Folstein, Folstein, McHugh, Mini-Mental State": A practical method for grading the cognitive status of patients for the clinician, J Psychiatr Res, 12, pp. 189-198, (1975)

[7]

Inouye, van Dyck, Alessi, Et al., Clarifying confusion: The confusion assessment method

[8]

a new method for detection of dementia, Ann Intern Med, 113, pp. 941-948, (1990)

[9]

Tombaugh, McIntyre, Mini-Mental State Examination: A comprehensive review, J Am Geriatr Soc, 40, pp. 922-935, (1992)

[10]

Knaus, Draper, Wagner, Et al., APACHE II: A severity of illness disease classification system, Crit Care Med, 13, pp. 818-829, (1985)

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