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Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study

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Authors
Choi, Jung-Yeon; Kim, Kwang-il; Kang, Min-gu; Lee, Young-Kyun; Koo, Kyung-Hoi; Oh, Joo Han; Park, Young Ho; Suh, Jeewon; Kim, Nak-Hyun; Yoo, Hyun-Jung; Koo, Jahyun; Moon, Hyun Mi; Kim, Eun Hui; Park, Kayoung; Kim, Cheol-Ho
Issue Date
2019-10-26
Publisher
BMC
Citation
BMC Geriatrics, 19(1):289
Keywords
DeliriumQuality improvement projectMultidisciplinary geriatric intervention
Abstract
Background
Postoperative delirium (POD) is a common clinical syndrome with significant negative outcomes. Thus, we aimed to evaluate the feasibility and effectiveness of a delirium screening tool and multidisciplinary delirium prevention project.

Methods
A retrospective cohort study was conducted at a single teaching center in Korea. A cohort of patients who underwent a delirium prevention program using a simple delirium screening tool from December 2018 to February 2019 (intervention group, N = 275) was compared with the cohort from the year before implementation of the delirium prevention program (December 2017 to February 2018) (control group, N = 274). Patients aged ≥65 years who were admitted to orthopedic wards and underwent surgery were included. The incidence rates of delirium before and after implementation of the delirium prevention program, effectiveness of the delirium screening tool, change in the knowledge score of nurses, and length of hospital stay were assessed.


Results
The sensitivity and specificity of the screening tool for the incidence of POD were 94.1 and 72.7%, respectively. The incidence rates of POD were 10.2% (control group) and 6.2% (intervention group). The odds ratio for the risk reduction effect of the project related to the incidence of POD was 0.316 (95% confidence interval: 0.125–0.800, p = 0.015) after adjustment for possible confounders. The delirium knowledge test score increased from 40.52 to 43.24 out of 49 total points (p < 0.001). The median length of hospital stay in the intervention and control groups was 6.0 (interquartile range, 4–9) and 7.0 (interquartile range, 4–10) days, respectively (p = 0.062).

Conclusion
The screening tool successfully identified patients at a high risk of POD at admission. The POD prevention project was feasible to implement, effective in preventing delirium, and improved knowledge regarding delirium among the medical staff.

Trial registration
None.
ISSN
1471-2318
Language
English
URI
https://doi.org/10.1186/s12877-019-1303-z

http://hdl.handle.net/10371/164399
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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