화상 중환자에서의 섬망과 사망

• 영문명: Delirium and Death in Burn Patients under Intensive Care
• 발행기관: 대한노인정신의학회
• 저자명: 서국희(Guk-Hee Suh) 신형직(Hyong Jik Shin) 함봉진(Bong Jin Hahm) 조성진(Seong-Jin Cho) 이동우(Dong-Woo Lee) 최인근(Ihn-Geun Choi) 손현균(Hyeon Gyun Son) 연병길(Byeong Kil Yeon)
• 간행물 정보: 『노인정신의학』노인정신의학 제3권 제2호, 165~173쪽, 전체 9쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 1999.12.30

영문 초록

Objective : This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. Method : The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction –especially disorientation–, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. Result : One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five；Age 65 and over (OR=45.51, 95% CI : 6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI : 3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI : 1.42-32.57), current medical disease (OR=3.00, 95% CI : 1.40-6.45), alcohol abuse (OR=3.17, 95% CI : 1.07-9.43) Statistically significant deathrelated risk factors were three；burn size over 60% of total body surface (OR=4.58, 95% CI : 2.00-10.46), delirium (OR=2.94, 95% CI : 1.25-6.94), current psychiatric disorder (OR=4.09,95% CI : 1.05-15.87). Aging is not the death-related factor in this study. Conclusion : Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.

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키워드

섬망 사망 유병률 화상 위험요인 Delirium Death Prevalence Burn Risk factor