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Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study.

Björkman Björkelund, Karin LU ; Hommel, Ami LU ; Thorngren, Karl-Göran LU ; Gustafson, Lars LU ; Larsson, Sylvia LU and Lundberg, Dag LU (2010) In Acta Anaesthesiologica Scandinavica Apr 7. p.678-688
Abstract
Background: There is an evident need for improved management of elderly patients with trauma in order to avoid common and troublesome complications such as delirium. The aim of this study was to investigate whether an implementation of a multi-factorial program including intensified pre-hospital and perioperative treatment and care could reduce the incidence of delirium in elderly patients with hip fracture, cognitively intact at admission to the hospital. In addition, we explored the factors that characterize patients who developed delirium. Methods: A prospective, quasi-experimental design was used. A total of 263 patients with hip fracture (>/=65 years), cognitively intact at admission, were consecutively included between April 2003... (More)
Background: There is an evident need for improved management of elderly patients with trauma in order to avoid common and troublesome complications such as delirium. The aim of this study was to investigate whether an implementation of a multi-factorial program including intensified pre-hospital and perioperative treatment and care could reduce the incidence of delirium in elderly patients with hip fracture, cognitively intact at admission to the hospital. In addition, we explored the factors that characterize patients who developed delirium. Methods: A prospective, quasi-experimental design was used. A total of 263 patients with hip fracture (>/=65 years), cognitively intact at admission, were consecutively included between April 2003 and April 2004. On 1 October 2003, a new program was introduced. All patients were screened for cognitive impairment within 30 min after admission to the emergency department using The Short Portable Mental Status Questionnaire (SPMSQ). To screen for delirium, patients were tested within 4 h of admission and thereafter daily, using the Organic Brain Syndrome scale. Results: The number of patients who developed delirium during hospitalization was 74 (28.1%), with a decrease from 34% (45 of 132) in the control group to 22% (29 of 131) in the intervention group (P=0.031). Patients who developed delirium were statistically older, more often had >4 prescribed drugs at admission and scored less well in the SPMSQ test. Conclusion: The use of a multi-factorial intervention program in elderly hip fracture patients, lucid at admission, reduced the incidence of delirium during hospitalization by 35%. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
Apr 7
pages
678 - 688
publisher
Wiley-Blackwell
external identifiers
  • wos:000278292400003
  • pmid:20236093
  • scopus:77953159789
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2010.02232.x
language
English
LU publication?
yes
id
fa8c8aaa-e5dd-42e3-9823-60044c4cb6a8 (old id 1581989)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20236093?dopt=Abstract
date added to LUP
2010-04-07 21:29:48
date last changed
2018-06-24 04:47:23
@article{fa8c8aaa-e5dd-42e3-9823-60044c4cb6a8,
  abstract     = {Background: There is an evident need for improved management of elderly patients with trauma in order to avoid common and troublesome complications such as delirium. The aim of this study was to investigate whether an implementation of a multi-factorial program including intensified pre-hospital and perioperative treatment and care could reduce the incidence of delirium in elderly patients with hip fracture, cognitively intact at admission to the hospital. In addition, we explored the factors that characterize patients who developed delirium. Methods: A prospective, quasi-experimental design was used. A total of 263 patients with hip fracture (>/=65 years), cognitively intact at admission, were consecutively included between April 2003 and April 2004. On 1 October 2003, a new program was introduced. All patients were screened for cognitive impairment within 30 min after admission to the emergency department using The Short Portable Mental Status Questionnaire (SPMSQ). To screen for delirium, patients were tested within 4 h of admission and thereafter daily, using the Organic Brain Syndrome scale. Results: The number of patients who developed delirium during hospitalization was 74 (28.1%), with a decrease from 34% (45 of 132) in the control group to 22% (29 of 131) in the intervention group (P=0.031). Patients who developed delirium were statistically older, more often had >4 prescribed drugs at admission and scored less well in the SPMSQ test. Conclusion: The use of a multi-factorial intervention program in elderly hip fracture patients, lucid at admission, reduced the incidence of delirium during hospitalization by 35%.},
  author       = {Björkman Björkelund, Karin and Hommel, Ami and Thorngren, Karl-Göran and Gustafson, Lars and Larsson, Sylvia and Lundberg, Dag},
  issn         = {0001-5172},
  language     = {eng},
  pages        = {678--688},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study.},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2010.02232.x},
  volume       = {Apr 7},
  year         = {2010},
}