Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Dec;68(12):2947-2954.
doi: 10.1111/jgs.16768. Epub 2020 Sep 9.

Multicomponent Interventions for the Prevention of Delirium in Hospitalized Older People: A Meta-Analysis

Beatriz León-Salas  1   2 , María M Trujillo-Martín  1   2   3 , Luis Pedro Martínez Del Castillo  4 , Javier García-García  4 , Pilar Pérez-Ros  5 , Francisco Rivas-Ruiz  2   6 , Pedro Serrano-Aguilar  2   3   7
Affiliations
Meta-Analysis

Multicomponent Interventions for the Prevention of Delirium in Hospitalized Older People: A Meta-Analysis

Beatriz León-Salas et al. J Am Geriatr Soc. 2020 Dec.

Abstract

Objectives: To comprehensively assess the effects of multicomponent interventions for prevention of delirium in hospitalized older people.

Design: Systematic review with meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses methods.

Participants: All randomized controlled trials were included. Included studies were conducted in hospitalized older people (aged ≥65 years).

Measurements: The electronic databases MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were consulted (search date: 2015 to March 2019). Predefined criteria were used to determine inclusion of studies and to assess their methodologic quality.

Results: From 1,250 records identified, 10 randomized controlled trials were included (n = 2,850: 1355 medical patients, 1,243 surgical, and 160 intensive care unit). The multicomponent interventions, compared with usual care, reduced the incidence of delirium (risk ratio (RR) = 0.62; 95% confidence interval (CI) = 0.54-0.72; I2 = 0%; k = 10; n = 2,758), duration of delirium (RR = -1.18; 95% CI = -1.95 to -0.40; I2 = 45%; k = 6; n = 276), severity of delirium (standard mean difference = -0.98; 95% CI = -1.46 to -0.49; I2 = 0%; k = 3; n = 82), and pressure ulcers (RR = 0.48; 95% CI = 0.26-0.88; I2 = 0%; k = 2; n = 457).

Conclusions: This meta-analysis suggests that multicomponent interventions to prevent delirium are effective in decreasing its incidence, duration, and severity; as well as the incidence of pressure ulcers in hospitalized older people. Therefore, multicomponent interventions hold great promise to impact in the most important and prevalent conditions affecting fragile older people during hospitalization.

Keywords: delirium; hospitalization; meta-analysis; multicomponent; older people; prevention.

PubMed Disclaimer

References

REFERENCES

    1. Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. Lancet. 2014;383:911-922.
    1. American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
    1. Desforges JF, Lipowski ZJ. Delirium in the elderly patient. N Engl J Med. 1989;320(9):578-582.
    1. Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing. 2006;35:350-364.
    1. Hubbard RE, Peel NM, Samanta M, Gray LC, Mitnitski A, Rockwood K. Frailty status at admission to hospital predicts multiple adverse outcomes. Age Ageing. 2017;46(5):801-806.

Publication types

LinkOut - more resources