地塞米松对老年COVID-19患者谵妄患病率的影响：一项回顾性队列研究

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2025-04-01 Epub Date: 2025-02-19 DOI:10.1007/s41999-024-01033-7

Chris van der Laan, Kristel Goossens, Sarah H M Robben, Mariette H W Kappers

{"title":"地塞米松对老年COVID-19患者谵妄患病率的影响：一项回顾性队列研究","authors":"Chris van der Laan, Kristel Goossens, Sarah H M Robben, Mariette H W Kappers","doi":"10.1007/s41999-024-01033-7","DOIUrl":null,"url":null,"abstract":"Purpose: Corticosteroids decrease mortality in patients with COVID-19 in need of oxygen therapy. However, corticosteroids are known to increase the risk of delirium in older patients. We studied whether dexamethasone increased the risk of delirium in older patients hospitalized with COVID-19.Methods: Single centre, retrospective cohort study including patients ≥ 70 years hospitalized in a large teaching hospital with COVID-19 during the first (control group) and second wave (dexamethasone group, receiving dexamethasone) of the COVID-19 pandemic. Only patients on regular (non-ICU) wards were included. Delirium was defined as having a mean delirium observation screening (DOS)-score of ≥ 3 or having an altered mental state on day 3 of admission.Results: We included 233 patients. The mean age in the dexamethasone group was 78.83 years [SD 6.5] compared to 79.43 years [SD 6.3] in the control group. In the dexamethasone group (n = 114), less patients developed delirium compared to the control group (n = 119) on day 3 of admission (5.3% vs 15.1%; p = 0.01). The Odds ratio of dexamethasone use for delirium was 0.23 (95% CI 0.08-0.64).Conclusion: In this study, dexamethasone did not increase the risk of delirium in older patients with COVID-19.","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"665-672"},"PeriodicalIF":3.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of dexamethasone on the prevalence of delirium in older COVID-19 patients: a retrospective cohort study.\",\"authors\":\"Chris van der Laan, Kristel Goossens, Sarah H M Robben, Mariette H W Kappers\",\"doi\":\"10.1007/s41999-024-01033-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Purpose: Corticosteroids decrease mortality in patients with COVID-19 in need of oxygen therapy. However, corticosteroids are known to increase the risk of delirium in older patients. We studied whether dexamethasone increased the risk of delirium in older patients hospitalized with COVID-19.Methods: Single centre, retrospective cohort study including patients ≥ 70 years hospitalized in a large teaching hospital with COVID-19 during the first (control group) and second wave (dexamethasone group, receiving dexamethasone) of the COVID-19 pandemic. Only patients on regular (non-ICU) wards were included. Delirium was defined as having a mean delirium observation screening (DOS)-score of ≥ 3 or having an altered mental state on day 3 of admission.Results: We included 233 patients. The mean age in the dexamethasone group was 78.83 years [SD 6.5] compared to 79.43 years [SD 6.3] in the control group. In the dexamethasone group (n = 114), less patients developed delirium compared to the control group (n = 119) on day 3 of admission (5.3% vs 15.1%; p = 0.01). The Odds ratio of dexamethasone use for delirium was 0.23 (95% CI 0.08-0.64).Conclusion: In this study, dexamethasone did not increase the risk of delirium in older patients with COVID-19.\",\"PeriodicalId\":49287,\"journal\":{\"name\":\"European Geriatric Medicine\",\"volume\":\" \",\"pages\":\"665-672\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Geriatric Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s41999-024-01033-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Geriatric Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s41999-024-01033-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：糖皮质激素可降低需要氧疗的COVID-19患者的死亡率。然而，皮质类固醇已知会增加老年患者谵妄的风险。我们研究了地塞米松是否会增加老年COVID-19住院患者谵妄的风险。方法：采用单中心、回顾性队列研究，纳入大型教学医院第一波（对照组）和第二波（地塞米松组，接受地塞米松治疗）新冠肺炎住院患者≥70岁。仅包括普通（非icu）病房的患者。谵妄定义为入院第3天谵妄观察筛查（DOS）平均评分≥3分或出现精神状态改变。结果：我们纳入了233例患者。地塞米松组患者平均年龄为78.83岁[SD 6.5]，对照组为79.43岁[SD 6.3]。在地塞米松组（n = 114）中，与对照组（n = 119）相比，入院第3天出现谵妄的患者较少(5.3% vs 15.1%；p = 0.01)。地塞米松治疗谵妄的优势比为0.23 （95% CI 0.08-0.64）。结论：在本研究中，地塞米松不会增加老年COVID-19患者谵妄的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The effect of dexamethasone on the prevalence of delirium in older COVID-19 patients: a retrospective cohort study.

Purpose: Corticosteroids decrease mortality in patients with COVID-19 in need of oxygen therapy. However, corticosteroids are known to increase the risk of delirium in older patients. We studied whether dexamethasone increased the risk of delirium in older patients hospitalized with COVID-19.

Methods: Single centre, retrospective cohort study including patients ≥ 70 years hospitalized in a large teaching hospital with COVID-19 during the first (control group) and second wave (dexamethasone group, receiving dexamethasone) of the COVID-19 pandemic. Only patients on regular (non-ICU) wards were included. Delirium was defined as having a mean delirium observation screening (DOS)-score of ≥ 3 or having an altered mental state on day 3 of admission.

Results: We included 233 patients. The mean age in the dexamethasone group was 78.83 years [SD 6.5] compared to 79.43 years [SD 6.3] in the control group. In the dexamethasone group (n = 114), less patients developed delirium compared to the control group (n = 119) on day 3 of admission (5.3% vs 15.1%; p = 0.01). The Odds ratio of dexamethasone use for delirium was 0.23 (95% CI 0.08-0.64).

Conclusion: In this study, dexamethasone did not increase the risk of delirium in older patients with COVID-19.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.