Multi-Component Care Bundle in Geriatric Fracture Hip for Reducing Post-Operative Delirium

Area of Science:

• Geriatric Medicine
• Orthopaedic Surgery
• Critical Care Medicine

Background:

• Delirium in elderly patients with hip fractures presents significant healthcare challenges.
• Post-operative delirium (POD) negatively impacts patient outcomes and increases healthcare costs.
• Effective interventions are needed to mitigate POD in this vulnerable population.

Purpose of the Study:

• To evaluate the efficacy of a Multi-component Care Bundle (MCB) in reducing the incidence of POD.
• To assess the impact of MCB on pain management, mobility, and length of stay in hip fracture patients.

Main Methods:

• An observational study involving 154 elderly hip fracture patients (mean age 85).
• Intervention group received MCB including orientation aids, caregiver empowerment, and ultrasound-guided Fascia Iliaca Block (FIB).
• Control group received standard care prior to MCB implementation.

Main Results:

• MCB group showed a significantly lower incidence of POD (23.4%) compared to the control group (44.2%).
• Patients in the MCB group consumed less opioid analgesia and experienced less post-operative dizziness.
• Median days to start walking post-operatively were reduced in the MCB group (Day 1 vs. Day 2).
• Length of hospital stay was not significantly affected by the MCB.

Conclusions:

• The Multi-component Care Bundle (MCB) is effective in reducing POD in elderly patients with hip fractures.
• MCB improves pain management, reduces dizziness, and accelerates postoperative mobilization.
• MCB offers a promising strategy to enhance recovery and reduce complications in orthopedic surgery patients.