怎么说到镇静问题上去了

Delirium is a common source of agitation in the ICU. Several risk factors contribute to the underrecognition of delirium in the ICU including older age, preexisting dementia, and vision impairment [5]. Although medication review and de-prescribing has previously been described as a potential strategy to treat delirium in the ICU, a recent multisite randomized clinical trial reported that an intervention to de-prescribe benzodiazepines and anticholinergics in patients with delirium did not reduce patient exposure to those medications, and therefore did not make a difference in delirium days, delirium severity, or mortality [6 &]. However, this intervention did not address sedation. Similarly, a pharmacological bundle to manage delirium in the ICU did not change delirium duration, severity, or mortality [7]. Ongoing studies including a 5-year randomized controlled trial to decrease polypharmacy in hospitalized older adults may provide more information about the impact of de-prescribing strategies on delirium [8]. More research is needed on specific medications used to treat delirium.

谵妄是ICU中常见的躁动源。几个危险因素（包括高龄、已存在的痴呆症和视力障碍）导致ICU对谵妄的认识不足。尽管检查可能导致谵妄的药物和不再向谵妄患者开具这些药物被描述为ICU中治疗谵妄的一种潜在策略，但最近的一项多点随机临床试验报告称：不再向谵妄患者开具苯二氮卓类药物和抗胆碱类药物的干预措施并不能减少患者使用这些药物的机会，因此对谵妄的天数、谵妄的严重程度或死亡率没有影响。然而，这种干预并没有解决镇静问题。类似地，ICU中管理谵妄的药理学上的集束化措施不会改变谵妄的持续时间、严重程度或死亡率。正在进行的研究中包括一项为期5年的随机对照试验的多药物研究，试图减少住院老年人中使用多种药物的情况，这可能会提供更多关于不再向患者开具可能导致谵妄药物的策略对谵妄影响的信息。还需要治疗谵妄特定药物的更多研究。

一直在说谵妄，怎么突然说到镇静问题上去了？死亡率啥意思？谵妄造成了死亡？