Abstract：【Objective】 To evaluate the value and clinical significance of procalcitonin level on delirium in ICU patients. 【Methods】 A total of 90 inpatients admitted to ICU of our hospital from January 30, 2016 to December 30, 2018 were enrolled. According to the ICU Consciousness Assessment Measurement Scale (CAM-ICU), patients were divided into the CAM-ICU positive group (patients with delirium) and the CAM-ICU negative group (patients without delirium) . Procalcitonin levels in peripheral blood were tested. The serum markers and clinical data were evaluated to the correlation with delirium; and multivariate analysis was used to assess the influencing factors of delirium. The receiver operating characteristic curve (ROC) was applied to analyze the predictive effect of procalcitonin levels on the occurrence of delirium in ICU patients. 【Results】 Of the 90 patients, 40 (44.4%) cases had delirium. There were 23 cases of procalcitonin level <0.5 μg/L, 41 cases of procalcitonin level at 0.5~2 μg/L, and 26 cases of procalcitonin level >2 μg/L. Patients with delirium and those without delirium had significant differences in the proportion of diabetes mellitus, serum procalcitonin, C-reactive protein and lactic acid (P<0.05). Multivariate analysis showed that procalcitonin level (95% CI:1.298-5.591), C-reactive protein (95% CI: 1.093-4.789), and lactate levels (95% CI:1.154-5.247) were independent influence factors of delirium (P< 0.05). The optimal threshold for procalcitonin levels to predict delirium in hospitalized ICU patients was 52.1. When the procalcitonin level was 52.1, the sensitivity of the procalcitonin level to predict delirium was 72.2%, the specificity was 82.4%. The area under the AUC curve was 0.82. 【Conclusion】 Inpatients with ICU who have elevated procalcitonin levels are more prone to delirium, and serum procalcitonin levels are effective biological indicators for predicting delirium in hospitalized ICU patients.
唐红梅, 鲁维. 降钙素原水平对ICU患者发生谵妄的影响及临床意义[J]. 医学临床研究, 2020, 37(4): 560-562.
TANG Hong-mei, LU Wei. Effect and Clinical Significance of Procalcitonin Level on Delirium of ICU Patients. JOURNAL OF CLINICAL RESEARCH, 2020, 37(4): 560-562.
[1] 潘利飞,叶向红,陈香萍, 等.ICU患者谵妄亚型、发生及持续时间的调查研究[J].中华现代护理杂志,2018,24(25):2990-2993. [2] Rosen T, Connors S, Clark S, et al. Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol[J].Adv Emerg Nurs J,2015,37(3):183-196, E3. [3] Hayhurst CJ, Pandharipande PP, Hughes C G. Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment[J].Anesthesiology,2016,125(6):1229-1241. [4] 刘金洁,刘思伯.老年性谵妄血清学标志物的研究进展[J].中华医学杂志,2018,98(47):3907-3909. [5] Bush SH, Lawlor PG. Delirium[J].CMAJ,2015,187(2):129. [6] Kukreja D, Gunther U, Popp J. Delirium in the elderly: Current problems with increasing geriatric age[J].Indian J Med Res,2015,142(6):655-662.) [7] Chan E, Shen Q, Cordato D, et al. Delirium post-stroke: short-to long-term effect on anxiety and depression compared to effect on cognition[J].Top Stroke Rehabil,2017,24(8):597-600. [8] Pisani MA, Kong SY, Kasl SV, et al. Days of delirium are associated with 1-year mortality in an older intensive care unit population[J].Am J Respir Crit Care Med,2009,180(11):1092-1097. [9] van den Boogaard M, Kox M, Quinn KL, et al. Biomarkers associated with delirium in critically ill patients and their relation with long-term subjective cognitive dysfunction; indications for different pathways governing delirium in inflamed and noninflamed patients[J].Crit Care,2011,15(6):R297. [10] Mcgrane S, Girard TD, Thompson JL, et al. Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients[J].Crit Care,2011,15(2):R78. [11] Maldonado JR. Neuropathogenesis of delirium: review of current etiologic theories and common pathways[J].Am J Geriatr Psychiatry,2013,21(12):1190-1222.
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