Effectiveness of Non-pharmacological Intervention Protocol for Prevention of Postoperative Delirium in the Surgical Intensive Care Unit

Overview

Journal Sci Rep

Date 2025 Jan 20

PMID 39833531

Authors

Thassayu Yuyen

Akarawat Narksut

Suchanun Lao-Amornphunkul

Chayanan Thanakiattiwibun

Cholticha Pansangar

Napat Thikom

Onuma Chaiwat

Annop Piriyapatsom

Affiliations

Soon will be listed here.

Abstract

Postoperative delirium (POD) is a common adverse event in patients admitted to the intensive care unit (ICU). We aimed to determine the effectiveness of a multicomponent non-pharmacological intervention protocol to reduce the incidence of POD in elderly patients admitted to the surgical ICU (SICU). This before-and-after cohort study included 300 patients aged ≥ 65 years who were admitted to the SICU within 7 days postoperatively with an anticipated SICU stay > 24 h. During the pre-intervention period, patients received medical care based on the attending physicians. While during the intervention, patients received the same medical care plus a multicomponent non-pharmacological intervention protocol. POD was monitored twice daily using the Confusion Assessment Method for the ICU. Demographic and clinical data during SICU stay were collected and compared between the pre-intervention and intervention periods. The primary outcome was POD incidence. The secondary outcomes were POD duration, delirium-free days, and other clinical outcomes. The incidences of POD during the pre-intervention and intervention periods were not different (40.0% vs. 38.0%, P = 0.723; OR 0.92, 95% CI 0.58-1.46). Multivariate regression analyses with two different models demonstrated that the multicomponent non-pharmacological intervention protocol was not associated with POD prevention (OR 0.70, 95% CI 0.39-1.25 for Model 1 and OR 0.63, 95% CI 0.37-1.08 for Model 2). The protocol was associated with lower incidence of SICU events, particularly self-removal of endotracheal tube and nosocomial infection. Implementation of the multicomponent non-pharmacological intervention protocol was not associated with POD prevention in elderly patients admitted to the SICU.Trial registration Thai Clinical Trials Registry. Trial No. TCTR20181201001. Retrospective registered 01 December 2018.

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