Reducing postoperative delirium in brain tumor patients through frailty-originated early rehabilitation: Findings from a prospective randomized study

Abstract

ObjectiveThis study aims to examine the effects of frailty-originated, evidence-based early activity training on postoperative delirium in patients who have undergone brain tumor resection. MethodsA randomized controlled trial was carried out at the Second Affiliated Hospital of Zhejiang University School of Medicine from July 2019 to June 2020. Data encompassing patients’ general information, delirium incidence and duration, hospitalization period, and daily activities were collected. Starting from the day after surgery, patients were randomly assigned to either the traditional care group or the group receiving frailty-originated rehabilitation tailored for intracranial tumors using distinct evidence (FORTITUDE). Non-parametric, chi-square, and log-rank tests were employed to compare the onset time and duration of postoperative delirium, as well as daily activities, between the two groups. ResultsThe study involved a total of 291 patients, with 150 in the control group and 141 in the FORTITUDE group. Patients in the FORTITUDE group exhibited a lower occurrence of postoperative delirium (15.6% vs. 28.7%, P = 0.007), delayed onset of delirium (Z = −2.108, P = 0.035), shorter duration of postoperative delirium (χ2; = 26.67, P < 0.001), reduced hospital stay (Z = −2.037, P = 0.042), and higher scores in activities of daily living at one week (Z = −2.304, P = 0.021) and one month (Z = −2.724, P = 0.006) post-surgery in comparison to the control group. ConclusionsThe FORTITUDE program demonstrated both safety and effectiveness in diminishing the incidence and duration of postoperative delirium while enhancing the quality of life for patients who underwent brain tumor resection.