국내 일 병원 중환자실에서 관찰한 섬망 환자의 예후
Impact of Delirium on Clinical Outcomes in Intensive Care Unit Patients : An Observational Study in a Korean General Hospital
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참고문헌
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초록
중환자실 재실 중 섬망을 경험하는 환자는 다른 인자들의영향을 통제한 후에도 퇴원시 사망률이 높고, 재실 기간 및입원 기간이 더 길어 본 연구의 가설과 일치하는 결과를 보였다. 이 결과는 국외 연구들에서 보고되어 온 바와 일치하며, 국내 종합병원 중환자실 환경의 환자군을 대상으로 하여그 상관관계를 처음으로 확인하였다는 의의가 있다. 이러한결과는 향후 국내 의료 환경에서 발생하는 섬망에 대한 탐색과 이에 대한 적절한 중재를 연구하는 데 기초 자료로서 활용될 것으로 기대한다.
Abstract
Objectives The purpose of this study is to evaluate the impact of delirium on clinical outcomes in intensive care unit (ICU) patients in a Korean general hospital. Methods All patients admitted to ICU from March 1, 2013 to October 31, 2013 were assessed by Confusion Assessment Method adapted for use in the ICU for delirium daily, and consistently comatose patients were excluded for analysis. Differences in clinical outcomes (mortality, length of hospital stay, length of ICU stay) were analyzed between delirious patients and non-delirious patients. Subsequently, the impact of delirium on clinical outcomes was analyzed with adjusting for covariates including surgery, age, emergent admission, presence of surgery, and severity of illness. Results The analysis included 129 delirious patients and 469 non-delirious patients. As primary outcome, mortality, length of stay (hospital day, ICU-stay) were significantly high in the delirious group. The association remained the same after adjusting for the covariates. Conclusion The results correspond with those of previous research studies conducted in foreign ICU. Based on this observation that delirium also has an impact on clinical outcomes in Korean ICU, integrative and in-depth investigation on ICU delirium will be needed.
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