Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study

Autor: Stig Karlsson, Maria Lundström, Birgitta Olofsson, Olle Svensson, Yngve Gustafson, Michael Stenvall, Undis Englund, Lars Nyberg, Bengt Borssén
Rok vydání: 2007
Předmět:
Zdroj: Aging Clinical and Experimental Research. 19:178-186
ISSN: 1720-8319
1594-0667
DOI: 10.1007/bf03324687
Popis: BACKGROUND AND AIMS: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures. METHODS: One hundred and ninety-nine patients, aged 70 years and over (mean age+/-SD, 82+/-6, 74% women), were randomly assigned to postoperative care in a specialized geriatric ward or a conventional orthopedic ward. The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria. RESULTS: The number of days of postoperative delirium among intervention patients was fewer (5.0+/-7.1 days vs 10.2+/-13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (56/102, 54.9% vs 73/97, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (pValiderad; 2007; 20070706 (andbra)
Databáze: OpenAIRE
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