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A Multifactorial Intervention Program Reduces the Duration of Delirium, Length of Hospitalization, and Mortality in Delirious Patients
Abstract
Objectives: To investigate whether an education program and a reorganization of nursing and medical care improved the outcome for older delirious patients. Design: Prospective intervention study. Setting: Department of General Internal Medicine, Sundsvall Hospital, Sweden. Participants: Four hundred patients, aged 70 and older, consecutively admitted to an intervention or a control ward. Intervention: The intervention consisted of staff education focusing on the assessment, prevention, and treatment of delirium and on caregiver‐patient interaction. Reorganization from a task‐allocation care system to a patient‐allocation system with individualized care. Measurements: The patients were assessed using the Organic Brain Syndrome Scale and the Mini‐Mental State Examination on Days 1, 3, and 7 after admission. Delirium was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria. Results: Delirium was equally common on the day of admission at the two wards, but fewer patients remained delirious on Day 7 on the intervention ward (n=19/63, 30.2% vs 37/62, 59.7%, P =.001). The mean length of hospital stay±standard deviation was significantly lower on the intervention ward then on the control ward (9.4±8.2 vs 13.4±12.3 days, P< .001) especially for the delirious patients (10.8±8.3 vs 20.5±17.2 days, P< .001). Two delirious patients in the intervention ward and nine in the control ward died during hospitalization ( P =.03). Conclusion: This study shows that a multifactorial intervention program reduces the duration of delirium, length of hospital stay, and mortality in delirious patients.
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Citations
Cited by
One-Year Health Care Costs Associated With Delirium in the Elderly Population
Leslie, D. L. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.4 · Cited by 1,040
Delirium in the intensive care unit
Girard, T. D., Pandharipande, P. P., & Ely, E. W. (2008) · Critical Care · doi:10.1186/cc6149 · Cited by 622
Interventions for preventing delirium in hospitalised non-ICU patients
Siddiqi, N., Harrison, J. K., Clegg, A., Teale, E. A., Young, J., Taylor, J., & Simpkins, S. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005563.pub3 · Cited by 619
The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults (2015) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13281 · Cited by 561
van den Boogaard, M., Schoonhoven, L., Evers, A. W. M., van der Hoeven, J. G., van Achterberg, T., & Pickkers, P. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e31822e9fc9 · Cited by 361
Metadata
- Authors
- Lundström, M., Edlund, A., Karlsson, S., Brännström, B., Bucht, G., & Gustafson, Y.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2005-03-30
- Volume
- 53
- Issue
- 4
- Pages
- 622-628
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1522413381
- Cited by
- 387
- References
- 0
- FWCI
- 15.37
- Type
- journal article
- Language
- en
- Open access
- closed
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- Lundström, M., Edlund, A., Karlsson, S., Brännström, B., Bucht, G., & Gustafson, Y. (2005). A Multifactorial Intervention Program Reduces the Duration of Delirium, Length of Hospitalization, and Mortality in Delirious Patients. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2005.53210.x
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