[Preventive program for postoperative delirium in the elderly]

Delirium is a poorly recognized entity in surgical patients that may commonly be mistaken for dementia or cognitive dysfunction. It is of great importance to know the measures that can lower its incidence and insure early recognition in order to begin specific treatment. The main objective of this study was to prove that implementation of an educational program for health care professionals is an effective strategy to reduce delirium incidence and to help in early detection.

A preventive program was developed based on non-pharmacological measures and with support from patient relatives consisting of educational sessions, didactic material and questionnaires, as well as specific strategies for all patients above 65 years old admitted to the hospital and within inclusion criteria. Two evaluations were made by physician and nursing personnel before and after implementation of the program.

We observed an improvement in ability to identify disease (initial 22% vs. 93%; p= 0.000). 200 patients were included in the study group in one year where only one case of delirium developed showing an important reduction compared to the previous incidence in our hospital (10% vs. 0.5% p= 0.000) whereas in the surgical patients group no patient developed delirium (4.8% vs. 0% p= 0.01, NNT= 21).

Implementation of a delirium prevention program is feasible. Due to the satisfactory results in our study it should be considered as an effective strategy for reducing incidence of this condition that may cause greater postoperative morbidity and mortality.K.