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

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815400/
https://www.ncbi.nlm.nih.gov/pubmed/31655551
http://dx.doi.org/10.1186/s12877-019-1303-z
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author 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
author_facet 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
author_sort Choi, Jung-Yeon
collection PubMed
description 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.
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spelling pubmed-68154002019-10-31 Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study 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 BMC Geriatr Research Article 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. BioMed Central 2019-10-26 /pmc/articles/PMC6815400/ /pubmed/31655551 http://dx.doi.org/10.1186/s12877-019-1303-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
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
Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title_full Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title_fullStr Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title_full_unstemmed Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title_short Impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
title_sort impact of a delirium prevention project among older hospitalized patients who underwent orthopedic surgery: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815400/
https://www.ncbi.nlm.nih.gov/pubmed/31655551
http://dx.doi.org/10.1186/s12877-019-1303-z
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