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Meta-Analysis
. 2020 Aug;68(8):1864-1871.
doi: 10.1111/jgs.16565. Epub 2020 Jun 12.

Non-Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People

Paul Ludolph  1 , Jutta Stoffers-Winterling  1   2 , Angela M Kunzler  2 , Romina Rösch  3 , Katharina Geschke  1 , Christian Friedrich Vahl  3 , Klaus Lieb  1   2
Affiliations
Meta-Analysis

Non-Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People

Paul Ludolph et al. J Am Geriatr Soc. 2020 Aug.

Abstract

Background/objectives: Delirium is a common neurobehavioral complication in hospitalized patients with a high prevalence in various clinical settings. Prevention of delirium is critical due to its common occurrence and associated poor outcomes. Our objective was to evaluate the efficacy of multicomponent interventions in preventing incident delirium in hospitalized patients at risk.

Design: Systematic review and meta-analysis.

Setting: Hospital.

Participants: We included a study if it was a randomized controlled trial and was evaluating effects of coordinated non-pharmacologic multicomponent interventions in the prevention of delirium.

Measurements: We performed a systematic literature search in PubMed and CENTRAL (PROSPERO: CRD42019138981; last update May 24, 2019). We assessed the quality of included studies by using the criteria established by the Cochrane Collaboration. We extracted the measured outcomes for delirium incidence, duration of delirium, length of hospital stay, falls during hospital stay, discharge to institutional care, and inpatient mortality.

Results: In total, we screened 1,027 eligible records and included eight studies with 2,105 patients in the review. We found evidence of an effect (ie, reduction) of multicomponent interventions on the incidence of delirium (risk ratio = .53; 95% confidence interval = .41-.69; I2 = 0). We detected no clear evidence of an effect for delirium duration, length of hospital stay, accidental falls, and mortality. Subgroup analyses did not result in findings of substantial effect modifiers, which can be explained by the high homogeneity within studies.

Conclusion: Our findings confirm the current guidelines that multicomponent interventions are effective in preventing delirium. Data are still lacking to reach evidence-based conclusions concerning potential benefits for hard outcomes such as length of hospital stay, return to independent living, and mortality. J Am Geriatr Soc 68:1864-1871, 2020.

Keywords: delirium; multicomponent interventions; non-pharmacologic interventions; prevention.

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References

REFERENCES

    1. Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-922.
    1. Fong TG, Jones RN, Marcantonio ER, et al. Adverse outcomes after hospitalization and delirium in persons with Alzheimer disease. Ann Intern Med. 2012;156(12):848-856, W296.
    1. Witlox J, Eurelings LSM, de Jonghe JFM, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443-451.
    1. Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA, Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009;249(1):173-178.
    1. Bellelli G, Mazzola P, Morandi A, et al. Duration of postoperative delirium is an independent predictor of 6-month mortality in older adults after hip fracture. J Am Geriatr Soc. 2014;62(7):1335-1340.

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