Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Comparison of Factors Associated With Agitation Among Youngest-Old, Middle-Old, and Oldest-Old Hospitalized Patients Referred to the Psychiatric Department

정신건강의학과에 협진의뢰된 연소노인, 고령노인, 초고령노인 입원환자의 초조의 연관요인 비교

  • Min-Suk Jang (Department of Psychiatry, Inha University College of Medicine) ;
  • Seo-Hyun Choi (Department of Psychiatry, Inha University College of Medicine) ;
  • Se-ri Maeng (Department of Psychiatry, Inha University College of Medicine) ;
  • Yang-Sik Kim (Department of Psychiatry, Inha University College of Medicine) ;
  • Jae-Nam Bae (Department of Psychiatry, Inha University College of Medicine) ;
  • Jeong-Seop Lee (Department of Psychiatry, Inha University College of Medicine) ;
  • Won-Hyoung Kim (Department of Psychiatry, Inha University College of Medicine)
  • 장민석 (인하대학교 의과대학 정신건강의학교실) ;
  • 최서현 (인하대학교 의과대학 정신건강의학교실) ;
  • 맹세리 (인하대학교 의과대학 정신건강의학교실) ;
  • 김양식 (인하대학교 의과대학 정신건강의학교실) ;
  • 배재남 (인하대학교 의과대학 정신건강의학교실) ;
  • 이정섭 (인하대학교 의과대학 정신건강의학교실) ;
  • 김원형 (인하대학교 의과대학 정신건강의학교실)
  • Received : 2023.07.26
  • Accepted : 2023.09.24
  • Published : 2023.12.31
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Abstract

Objectives : In this study, elderly hospitalized patients aged 65 years or older who were admitted to a university hospital and referred to the department of psychiatry were classified into youngest-old, middle-old, and oldest-old. It was conducted to find out what factors contribute to the agitation pattern by age group, whether there is a difference in the factors, and whether there is a difference in the severity of the agitation pattern. Methods : From July 1, 2021 to December 31, 2021, the medical records of patients aged 65 years or older who were referred to the department of psychiatry were retrospectively reviewed. Age, gender, route of hospitalization, department of referral, reason for referral, treatment method, presence of internal and surgical diseases, and hematological test data were investigated. Results : There was a significant correlation with the RASS score in cases of surgery referral and high CRP levels for youngest-old aged 65 to 74 years, in cases of surgery referral, dementia and hyponatremia for middle-old aged 75 to 84 years, in case of dementia for oldest-old aged 85 years old or older. In addition, there were differences in the severity of agitation patterns between age groups. Conclusions : As the age group increases, the agitation of delirium patients becomes more severe, and various factors contributing to the agitation pattern also differ by age group. Therefore, when treating elderly patients with delirium, attention should be paid to factors that may affect agitation depending on age.

연구목적 본 연구는 일 대학병원에 입원하여 정신건강의학과로 협진 의뢰가 된 65세 이상의 노인 입원 환자들을 연소노인, 고령노인, 초고령노인으로 분류하여, 각 연령대별로 초조(agitation) 양상에 기여하는 요인 및 차이, 초조 양상의 심각도에 대한 차이를 알아보기 위해 시행되었다. 방 법 2021년 7월 1일부터 2021년 12월 31일까지 인하대병원에 입원한 환자 중, 정신건강의학과에 협진 의뢰된 65세 이상 환자들의 의무기록을 후향적으로 검토하였다. 연령, 성별, 입원경로, 의뢰과, 의뢰 사유, 치료방법, 내외과적 질환여부, 혈액학적 검사자료 등을 조사하였다. 결 과 65-74세의 연소노인은 외과계열 협의진료 의뢰(OR 4.833, 95% CI 1.533-15.234, p=0.007), 높은 CRP수치(OR 2.111, 95% CI 1.007-4.426, p=0.048)에 해당될 경우, 75~84세의 고령노인은 외과계열 협의진료 의뢰(OR 3.568, 95% CI 1.334-9.544, p=0.011), 치매(OR 5.503, 95% CI 1.164-26.026, p=0.031), 저나트륨혈증(OR 0.344, 95% CI 0.149-0.791, p=0.012)에 해당될 경우, 85세이상의 초고령노인은 치매(OR 9.728, 95% CI 1.151-82.242, p=0.037)에 해당될 경우 초조와 유의한 관련성이 있었다. 또한 RASS 평균점수의 경우 65-74세의 연소노인은 1.22점, 75-84세의 고령노인은 1.54점, 85세이상의 초고령노인은 1.79점(F=5.368, p=0.005)으로 연령대 간의 초조 양상의 심각도에 대한 차이가 있었다. 결 론 연령대가 증가함에 따라 초조 양상의 심각도가 높게 나타났고, 초조 양상에 기여하는 여러 관련 요인들도 연령대 별로 차이가 있었다. 따라서, 고령 환자 진료시 연령대에 따라 초조에 영향을 미칠 수 있는 인자에 대한 주의가 필요하다.

Keywords

Acknowledgement

한국보건산업진흥원 보건의료기술연구개발사업의 지원을 받아 수행된 연구임(Grant HI22C1884).

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