159

Abstract

Introduction: The purpose of this study was to evaluate the impact of multifaceted preoperative patient education and to explore the predictors of delirium, mechanical ventilation, and intensive care unit length of stay (LOS) in patients who received preoperative education regarding what to expect of their ICU stay. Methods: A prospective, randomized controlled trial was conducted on consented patients undergoing pulmonary thromboendarterectomy from October 2011 to April 2013. Patients were randomized in 1:1 ratio to receive either an individualized 45-minute multifaceted preoperative education (experimental group, n=63) or standard of care preoperative education (control group, n=66). Participants completed a knowledge test and the State-Trait Anxiety Inventory before and after the education. Patient satisfaction, delirium assessment, days of mechanical ventilation, ICU LOS, and cardiopulmonary parameters were collected postoperatively. Results: The experimental group had significant improvement in postoperative care knowledge (p<0.001) and fewer days of mechanical ventilation (p=0.038) compared to the control group. No statistically significant differences were observed in anxiety, satisfaction, ICU LOS, and incidence of delirium. In exploratory multivariate analyses, hearing impairment was a statistically significant positive predictor for days of delirium (p=0.009), days of mechanical ventilation (p<0.001), and ICU LOS (p=0.049); whereas the posttest knowledge was a statistically significant negative predictor for days of mechanical ventilation (p=.018). Conclusions: The multifaceted preoperative patient education appeared to be effective in improving knowledge and reducing days of mechanical ventilation. Hearing impairment was an unexpected negative predictor of patient outcomes.