The effectiveness evaluation of multiple discipline intervention for delirium diagnosis and treatment in elderly inpatients

Abstract

Objective To explore the effectiveness evaluation of multiple discipline intervention for delirium diagnosis and treatment in elderly inpatients. Methods A total of 429 elderly inpatients were assessed by the multiple risk factors. 123 of them were with moderate or high risk for delirium and they were randomly divided into two groups: the intervention group (n=61) received a systematic multi-factor intervention of medical, nursing, nutritional, pharmacological intervention and care education, and the control group (n=62) received routine medical care without any special intervention. The incidence, severity (DRS-R-98), treatment (sedative, antipsychotic medications, physical restraint), and prognosis (complications, duration of delirium, mortality) of delirium were recorded. Results Less patients developed delirium in the intervention group (49.2%, 30/61) than in control (67.7%, 42/62) χ2=4.37, P=0.040). Length of stay in hospital was less in the intervention group than in control group 〔(18.6±6.7)d vs.(24.2±8.8)d, (t=3.18, P=0.020)〕. Less delirious patients were prescribed sedatives in the intervention group (13.3%, 4/30) than in control (35.7%, 15/42) χ2=4.51, P=0.030), and prescribed also antipsychotic medicine〔(13.3%, 4/30) vs. (38.1%, 16/42), χ2=5.35, P=0.020〕. The duration of delirium was shorter in the intervention group than in control group 〔(1.9±0.9)d vs. (3.5±1.6)d, t=2.10, P=0.040〕. Conclusions Risk factors assessment and multi-factorial intervention can prevent onsets of delirium and improve its outcomes effectively in elderly inpatients. Key words: Delirium; Intervention studies; Prognosis