Reducing acute confusional states in elderly patients with hip fractures

Abstract

The extent to which the incidence of postoperative acute confusional states could be reduced in elderly (greater than or equal to age 60) patients with hip fractures was tested. Interpersonal and environmental nursing interventions were carried out with 57 patients on orthopedic units in three hospitals. The incidence of confusion was reduced from 51.5% in the comparison group (n = 170) to 43.9%. Analysis that controlled for risk factors in the two groups showed the drop in incidence to be significant (p less than .02). The most effective interventions appeared to be those that provided orientation and clarification, corrected sensory deficit, and increased continuity of care.

Delirium risk factors in elderly hospitalized patients

“…3,4 Delirium is often not recognized, [5][6][7] and intervention benefits to date have shown to be limited. [8][9][10] Thus, prevention through identification of a high-risk group is indicated.…”

Postoperative mental impairment in hip fracture patients: A randomized study of reorientation measures in 223 patients

“…The factors of importance may rather be the organization and treatment on the hospital ward. Williams et al (1985) showed a positive effect with increased continuity and education of the nurses. So-called active reorientation measures have proved to be valuable after open heart surgery (Budd and Brown 1974).…”

“…It has been noted in one third to one half of the patients on admission to hospital (Gustafson et al 1991, Ogilvie-Harris et al 1993). An equally large number of patients have been found to develop mental deterioration postoperatively (Williams et al 1985, Gustafson et al 1988. This is associated with an increased incidence of local and systemic complications (Berggren et al 1987, O'Brien et al 1993, Svensson et al 1996.…”

Post stroke delirium

“…Для больного должно быть создано адекватное окруже-ние, с минимальным числом смен палаты и место-положения, персонала, низкой освещенностью па-латы по ночам и минимальным уровнем шума. Только в ограниченном числе исследований изучал-ся вопрос об эффективности когнитивных, эмоцио-нальных и средовых вмешательств при лечении де-лирия [55][56][57][58], но такие вмешательства стали стан-дартными рекомендациями, базирующимися на клиническом опыте, здравом смысле и отсутствии побочных эффектов [59].…”