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Delirium's Arousal Subtypes and Their Relationship with 6-Month Functional Status and Cognition

机译：谵妄的唤醒亚型及其与6个月的职能状况和认知的关系

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Objective: We sought to determine how delirium subtyped by arousal affected 6-month function and cognition in acutely ill older patients. Methods: This was secondary analysis of a prospective cohort study which enrolled hospitalized patients >= 65 years old. Delirium and arousal were ascertained daily in the emergency department and the first 7 days of hospitalization using the modified Brief Confusion Assessment Method and Richmond Agitation Sedation Scale, respectively. For each day, patients were categorized as having no delirium, delirium with normal arousal, delirium with decreased arousal, or delirium with increased arousal. Preillness and 6-month functional status were determined using the Older American Resources and Services activities of daily living scale which ranges from 0 (completely dependent) to 28 (completely independent). Preillness and 6-month cognition were determined using the Informant Questionnaire on Cognitive Decline in the Elderly which ranges from 1 (markedly improved cognition) to 5 (severe cognitive impairment). Multiple linear regression was performed adjusted for preillness Older American Resources and Services activities of daily living and Informant Questionnaire on Cognitive Decline in the Elderly and other relevant confounders. Results: In 228 older patients, delirium with normal arousal was the only subtype independently associated with poorer 6-month function and cognition. For every day spent in this subtype, the 6-month Older American Resources and Services activities of daily living decreased by 0.84 points (95% confidence interval: -1.59 to -0.09) and the patient's 6-month Informant Questionnaire on Cognitive Decline in the Elderly significantly increased by 0.14 points (95% confidence interval: 0.06-0.23). Conclusions: Delirium with normal arousal, as opposed to delirium with decreased or increased arousal, was the only arousal subtype significantly associated with worsening 6-month function and cognition. Subtyping delirium by arousal may have important prognostic value.
机译：目的：我们试图确定令人痛苦的令人痛苦的6个月功能和认知在急性病老年患者中的亚血症。方法：这是对预期群体的次要队列研究的二级分析，注册住院患者> = 65岁。谵妄和唤醒人员每天在急诊部门确定，分别使用修改的短暂混淆评估方法和中学搅动镇静尺度分别在医院治疗的前7天。每天，患者被分类为没有谵妄，谵妄具有正常唤醒，令人衰减的谵妄，或令人衰退的谵妄。预填/ 6个月的功能状态是使用年龄较旧的美国资源和服务的日常生本规模的活动确定，其范围从0（完全依赖）到28（完全独立）。预填充和6个月的认知是利用年龄的认知衰退的信息，从1（显着改善认知）到5（严重的认知障碍）来确定。针对预填充旧的美国资源和服务活动进行了多元线性回归，以及日常生活和信息调查问卷对老年人的认知下降和其他相关混杂者的认知下降。结果：228名老年患者，具有正常唤醒的谵妄是唯一与6个月功能和认知的唯一相关的亚型。对于这一亚型的每一天，6个月的老年人资源和服务日常生活活动减少0.84分（95％的置信区间：-1.59至-0.09）和患者的6个月内信息问卷对认知下降老年人显着增加0.14分（95％置信区间：0.06-0.23）。结论：与令人减少或增加的谵妄相比，谵妄与谵妄相反，是令人衰退的谵妄，是唯一与恶化6个月的功能和认知的令人显着相关的令人惊叹的亚型。令人讨厌的亚型谵妄可能具有重要的预后价值。

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