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J Am Geriatr Soc. 2005 Apr;53(4):622-8.

A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients.

Author information

  • 1Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87 Umeå, Sweden. maria.lundstrom@germed.umu.se

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.

PMID:
15817008
[PubMed - indexed for MEDLINE]
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