Reduction in Post-Op Delirium With mHELP Program
FRIDAY, May 26, 2017 -- For older patients undergoing abdominal surgery, participating in a modified Hospital Elder Life Program (mHELP) is associated with a reduced risk of postoperative delirium and with shorter length of stay, according to a study published online May 24 in JAMA Surgery.
Cheryl Chia-Hui Chen, R.N., from the National Taiwan University in Hsinchu, and colleagues conducted a cluster randomized trial involving 377 older patients (≥65 years) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy. Participants were cluster randomized by room to receive the mHELP intervention or usual care (197 and 180 patients, respectively). The intervention consisted of orienting communication, oral and nutritional assistance, and early mobilization, administered daily. All three mHELP protocols were administered to intervention group participants postoperatively, in addition to usual care, from arrival in the surgery ward through discharge.
The researchers found that postoperative delirium occurred in 6.6 and 15.1 percent of mHELP participants and controls (relative risk, 0.44 in the mHELP group). Participants in the mHELP group received the intervention for a median of seven days, and had a shorter median length of stay than control patients (12.0 versus 14.0 days).
"Our findings support using the mHELP to advance postoperative care for older patients undergoing major abdominal surgery," the authors write.
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Posted: May 2017