Aim: The aims of this study are: (a) to determine the incidence of postoperative delirium (POD) among surgical intensive care unit (ICU) patients in China and identify risk factors, especially, which are modifiable and have value for developing a prediction model; (b) to develop and validate a prediction model of delirium to recognize high-risk patients in surgical ICUs; (c) to investigate the short- and long-term outcomes of delirious patients and identify the predictors of patient outcomes.
Design: A single-centre prospective cohort study.
Methods: Patients will be enrolled from three surgical ICUs in a tertiary teaching hospital. Delirium assessment and perioperative data will be collected throughout the hospitalization. Delirious patients will be followed up for 2 years. The study was approved by the ethics committee in May 2018 and was funded by the clinical research grant from Zhongshan hospital, Fudan University, Shanghai.
Discussion: Developing POD can be a burden to patients both for the short- and long-term period. Due to the lack of effective treatments for POD, prevention remains the best strategy. This study will provide an effective tool for early screening of high-risk patients of POD and provide a better understanding of the aetiology and outcome of delirium.
Impact: In clinical practice, a prediction model will offer an effective tool for ICU nurses to assess high-risk patients, which can support them to implement preventive strategies at the early stages to targeted patients. The follow-up results will help us better understand the impact of delirium on patients' long-term outcome.
目的: 本研究的目的是:(a)确定中国外科重症监护病房(ICU)患者术后精神失常(POD)的发病率并确定风险因素。尤其是可改变且对建立预测模型有价值的风险因素;(b)建立和验证精神失常的预测模型,以识别外科外科重症监护病房中的高危患者;(c)研究精神失常患者的短期和长期结果,并确定患者结果的预测因素。 设计: 单中心前瞻性队列研究。 方法: 将登记三级教学医院三个外科重症监护病房的患者。住院期间收集精神错乱评估和围手术数据并对精神错乱患者随访2年。本次研究于2018年五月获得伦理委员会批准,由上海复旦大学中山医院临床研究基金资助。 讨论: 无论是短期还是长期,术后精神失常都可能成为患者的负担。由于缺乏术后精神失常的有效治疗措施,预防仍然是最佳对策。本次研究将为术后精神失常高危患者的早期筛选提供有效工具并能更好地理解精神失常的病因和结果。 影响: 在临床实践中,预测模式将为重症监护病房护士提供评估高危患者、帮助他们在早期对目标患者实施预防策略有效工具。随访结果将有助于我们更好地了解精神失常对患者的长期影响。.
Keywords: critical care; delirium; intensive care unit; nursing; postoperative care; prediction model; protocol; surgical patients.
© 2019 John Wiley & Sons Ltd.