How Can Delirium Best Be Prevented and Managed in Older Patients in Hospital
CMAJ: Canadian Medical Association Journal
Holroyd-Leduc, J. M., Khandwala, F., et al. (2010).
CMAJ: Canadian Medical Association Journal, 182(5), 465-470.
<div>This literature review investigates the effects of various treatments on the prevention and management of delirium hospitalized patients aged 65 and over. This article summary only reports findings relevant to the scope of practice of speech-language pathology. </div>
No funding received
<div><span class="TextRun SCXW89661825 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun AdvancedProofingIssueV2Themed SCXW89661825 BCX0">The data in this systematic review are included in another document which can be found in the Associated Article section below.</span></span></div>
From database inception to October 2007
<div>Randomized controlled trials</div>
11 (6 within scope)
<div>Preventative multicomponent programs appeared to benefit hospitalized older adults with hip fractures at risk of developing delirium. The following findings were reported across 3 studies:</div>
<div>
<ul>
<li>Multicomponent programs reduced delirium incidence (Relative Risk [RR] = 0.75).</li>
<li>Hospital length of stay was reduced in 1 out of 3 studies, with no impact on discharge location.</li>
<li>Hospital mortality was reduced in 1 out of 2 studies.</li>
<li>Patients experienced fewer adverse events (e.g., pressure ulcers, infections, falls) in 2 out of 2 studies.</li>
</ul>
<div>Additional research is indicated due to a limited number of available studies.</div>
</div>
<div>Multicomponent programs designed to manage delirium in hospitalized older patients did not impact:</div>
<div>
<ul>
<li>hospital mortality (3 studies);</li>
<li>hospital length of stay (2 studies);</li>
<li>independence following discharge (2 studies);</li>
<li>overall function (1 study); or</li>
<li>need for institutional care (1 study).</li>
</ul>
<div>Limitations to these findings include limited available research and heterogeneity between studies. Additional research is needed. </div>
</div>
