Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit
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...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-86768-4 |
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| author | Thassayu Yuyen Akarawat Narksut Suchanun Lao-amornphunkul Chayanan Thanakiattiwibun Cholticha Pansangar Napat Thikom Onuma Chaiwat Annop Piriyapatsom |
| author_facet | Thassayu Yuyen Akarawat Narksut Suchanun Lao-amornphunkul Chayanan Thanakiattiwibun Cholticha Pansangar Napat Thikom Onuma Chaiwat Annop Piriyapatsom |
| author_sort | Thassayu Yuyen |
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| description | 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. |
| format | Article |
| id | doaj-art-f44d8475e7c6445d888956b3601a18d7 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-f44d8475e7c6445d888956b3601a18d72025-01-26T12:25:07ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-025-86768-4Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unitThassayu Yuyen0Akarawat Narksut1Suchanun Lao-amornphunkul2Chayanan Thanakiattiwibun3Cholticha Pansangar4Napat Thikom5Onuma Chaiwat6Annop Piriyapatsom7Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Surgical and Orthopedic Surgery Nursing, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Surgical and Orthopedic Surgery Nursing, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract 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.https://doi.org/10.1038/s41598-025-86768-4Delirium preventionElderly patientsNon-pharmacological interventionPostoperative deliriumPreventionSurgical intensive care unit |
| spellingShingle | Thassayu Yuyen Akarawat Narksut Suchanun Lao-amornphunkul Chayanan Thanakiattiwibun Cholticha Pansangar Napat Thikom Onuma Chaiwat Annop Piriyapatsom Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit Scientific Reports Delirium prevention Elderly patients Non-pharmacological intervention Postoperative delirium Prevention Surgical intensive care unit |
| title | Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| title_full | Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| title_fullStr | Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| title_full_unstemmed | Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| title_short | Effectiveness of non-pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| title_sort | effectiveness of non pharmacological intervention protocol for prevention of postoperative delirium in the surgical intensive care unit |
| topic | Delirium prevention Elderly patients Non-pharmacological intervention Postoperative delirium Prevention Surgical intensive care unit |
| url | https://doi.org/10.1038/s41598-025-86768-4 |
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