Background:

Acupuncture seems to improve cognitive function in experimental models and to reduce agitation in dementia. The addition of acupuncture to standard-of-care (SOC) may improve clinical outcomes related to delirium in hospitalized older adults.

Methods:

This pragmatic open-label randomized-controlled trial evaluated 81 older adults hospitalized in an internal medicine ward and diagnosed with delirium. Fifty were randomized to daily acupuncture combined with SOC and 31 to SOC only for up to 1 week. Delirium was diagnosed using Confusion Assessment Method (CAM) tool, and its severity was assessed by the long CAM-Severity (CAM-S) tool. The primary study outcome was delirium resolution evaluated as time-to-first delirium remission (over 7 days) and the number of days spent delirium-free.

Results:

Time-to-first delirium remission was shorter in the acupuncture arm as compared to the SOC only arm (p < 0.001). A multivariate Cox regression analysis showed a shorter time-to-first remission of delirium in the acupuncture arm as compared with SOC arm [Hazard Ratio 0.267 (95% CI 0.098-0.726, p = 0.010)]. In the 7 days of evaluation, a significantly higher number of delirium-free days was found in the acupuncture arm compared to the SOC arm (p < 0.001), and CAM-S sum from day 2 to day 7 of evaluation was significantly lower in the acupuncture group compared to the control group (p = 0.002). No adverse safety event was found in the acupuncture group.

Conclusion:

Acupuncture seems to be safe and effective in the treatment of delirium in older patients hospitalized in internal medicine departments.

中文翻译：

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针灸治疗老年住院内科谵妄：一项开放标签实用随机对照试验

背景：

针灸似乎可以改善实验模型中的认知功能并减少痴呆症的躁动。在标准护理 (SOC) 中添加针灸可能会改善住院老年人谵妄相关的临床结果。

方法：

这项务实的开放标签随机对照试验评估了 81 名在内科病房住院并被诊断为谵妄的老年人。50 人随机接受每日针灸联合 SOC，31 人随机接受 SOC 最多 1 周。谵妄使用混淆评估方法 (CAM) 工具诊断，其严重程度由长 CAM-Severity (CAM-S) 工具评估。主要研究结果是谵妄缓解评估为首次谵妄缓解的时间（超过 7 天）和无谵妄的天数。

结果：

与仅 SOC 组相比，针灸组首次谵妄缓解的时间更短（p < 0.001）。多变量 Cox 回归分析显示，与 SOC 组相比，针灸组谵妄首次缓解的时间更短 [风险比 0.267 (95% CI 0.098-0.726，p = 0.010)]。在 7 天的评估中，针灸组的无谵妄天数显着高于 SOC 组（p < 0.001），评估第 2 天到第 7 天的 CAM-S 总和显着低于 SOC 组。针灸组与对照组相比（p = 0.002）。针刺组未发现不良安全事件。

结论：

针灸治疗内科住院老年患者谵妄似乎是安全有效的。