Delirium in COVID-19 and post-liver transplant patients: an observational study.

IF 2.9 4区医学 Q2 PSYCHIATRY

International Journal of Psychiatry in Clinical Practice Pub Date : 2022-11-01 Epub Date: 2022-01-21 DOI:10.1080/13651501.2022.2026403

Gianluca Fiore, Silvia Ferrari, Anna Cutino, Claudia Giorgino, Laura Valeo, Gian M Galeazzi, Mattia Marchi

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引用次数: 1

Abstract

Objective: Delirium is a major complication in hospitalised patients. This study aimed to compare the mortality trends of patients with delirium according to the underlying physical condition.

Methods: Hospitalised patients diagnosed with delirium by the Modena Consultation-Liaison Psychiatry Service (Italy) during 2020 were enrolled. Three groups were identified: COVID; after orthotopic liver transplant (OLT); other conditions. The full medical records were screened to retrieve socio-demographic and clinical data. INTERMED score and Delirium Rating Scale were used to retrospectively rate bio-social-complexity and delirium severity. Early (20 days) and end of study (31^st January 2021) mortality were ascertained for each subject.

Results: A total of 103 patients were enrolled. Patients hospitalised for COVID showed higher INTERMED scores (two-tailed t-test, p = 0.019) and higher 20-day mortality (HR = 3.68, p = 0.014). When considering a 1-year follow-up, the main predictor of mortality was patients' age in all three subgroups (HR = 1.06; p = 0.003).

Conclusion: Our results suggest that patients hospitalised for COVID-19 with delirium showed higher bio-psycho-social complexity and higher short-term mortality, regardless of the severity of delirium. OLT patients showed lower mortality and bio-psycho-social complexity, despite being still considered as 'complex', according to the INTERMED score. Future research should focus on understanding the underlying mechanisms in the relationship between delirium and mortality.Key pointsPatients hospitalised for COVID-19 with delirium were found at risk of higher short-term mortality and higher bio-psycho-social complexity.OLT patients showed lower overall mortality and lower bio-psycho-social complexity than the other two groups, despite being still in the 'complex' range according to the INTERMED score.Future research should assess the areas of impact of delirium in patients affected by COVID-19, considering short- and long-term outcomes.

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COVID-19和肝移植后患者谵妄:一项观察性研究

目的:谵妄是住院患者的主要并发症。本研究的目的是比较谵妄患者的死亡率趋势，根据潜在的身体状况。方法:纳入2020年期间由意大利摩德纳咨询-联络精神病学服务中心诊断为谵妄的住院患者。分为三组:COVID;原位肝移植(OLT)后;其他条件。对完整的医疗记录进行筛选，以检索社会人口统计学和临床数据。采用INTERMED评分和谵妄评定量表回顾性评价生物社会复杂性和谵妄严重程度。确定每个受试者的早期(20天)和研究结束(2021年1月31日)死亡率。结果:共纳入103例患者。住院患者的INTERMED评分较高(双尾t检验，p = 0.019)， 20天死亡率较高(HR = 3.68, p = 0.014)。当考虑1年随访时，三个亚组中死亡率的主要预测因子是患者的年龄(HR = 1.06;p = 0.003)。结论:我们的研究结果表明，无论谵妄严重程度如何，COVID-19合并谵妄住院的患者表现出更高的生物心理社会复杂性和更高的短期死亡率。根据INTERMED评分，OLT患者表现出较低的死亡率和生物-心理-社会复杂性，尽管仍被认为是“复杂”。未来的研究应侧重于了解谵妄与死亡率之间关系的潜在机制。新型冠状病毒肺炎合并谵妄住院患者有较高的短期死亡率和较高的生物心理社会复杂性。尽管根据INTERMED评分，OLT患者仍处于“复杂”范围，但OLT患者的总体死亡率和生物心理社会复杂性均低于其他两组。未来的研究应评估受COVID-19影响的患者谵妄的影响领域，考虑短期和长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Psychiatry in Clinical Practice 医学-精神病学

CiteScore

6.00

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Psychiatry in Clinical Practice provides an international forum for communication among health professionals with clinical, academic and research interests in psychiatry. The journal gives particular emphasis to papers that integrate the findings of academic research into realities of clinical practice. Focus on the practical aspects of managing and treating patients. Essential reading for the busy psychiatrist, trainee and interested physician. Includes original research papers, comprehensive review articles and short communications. Key words: Psychiatry, Neuropsychopharmacology, Mental health, Neuropsychiatry, Clinical Neurophysiology, Psychophysiology, Psychotherapy, Addiction, Schizophrenia, Depression, Bipolar Disorders and Anxiety.