Abstract
OBJECTIVES
Postoperative delirium is a common, life-threatening problem in older adults. However, research on multidisciplinary prevention of delirium in China is limited. We adapted the Hospital Elder Life Program (HELP) for using it on six surgical wards in a Chinese hospital and assessed its effect and feasibility by conducting a cluster randomized trial.
METHODS
We modified the HELP mode by adapting it to Chinese medical environment and culture. It included personnel composition, assignment of responsibility, multidisciplinary intervention protocols, implementation procedure, and personnel training. A total of 261 patients aged 70 and older undergoing elective surgery were recruited. After baseline assessment, eligible patients, in clusters, were randomly assigned to the multicomponent intervention group or usual care group.
RESULTS
Delirium occurred in 12/140 (8.6%) intervention group, versus 25/121 (20.6%) usual-care patients (P ＜0.05). The length of hospital stay in the control group was significantly longer than that in the intervention group（16.41 ± 4.69 vs. 12.15 ± 3.78，P<0.05）. The score of satisfaction towards hospital service in the intervention group was significantly higher than that in the control group（94.44 ± 6.29 vs.85.07 ± 5.72，P<0.05）. The severity of delirium between the intervention group and control group showed no difference (P>0.05). The adherence of early movement was highest（74.3%）.
CONCLUSIONS
This perioperative multidisciplinary intervention was successfully implemented in a Chinese hospital and it was effective for the prevention of postoperative delirium.