Cost-Effectiveness of Music for Preventing Postoperative Delirium in Elderly Hip Fracture Patients

Postoperative delirium (POD) is a major health issue associated with considerable health-care costs. Perioperative music is a promising intervention that decreases the risk of delirium. This study investigates whether perioperative music is a cost-effective intervention for preventing POD in elderly hip fracture patients.

The analysis is based on a multicenter randomized controlled trial (Dutch Trial Register ID: NTR7036). A total of 399 patients aged 65 y or older who underwent acute hip fracture surgery were included. The music group received prerecorded music, whereas the control group received standard-of-care. The primary outcomes were delirium incidence and health-care costs during primary admission and follow-up until 90 d after admission. The secondary outcomes included the Delirium Observational Screening Scale, nursing home admissions, and functional independence.

POD occurred significantly less often in the music group compared to the control group (14 (7.4%) versus 29 (13.8%), P = 0.039) during admission. Primary hospital admission costs were comparable between the music group and the control group (€7749; 95% confidence interval [CI]: 7256-8290 vs. €7723; 95% CI: 7219-8230; mean difference = €27). In addition, the total costs were comparable between both groups (music group €12,078; 95% CI: 10,470-13,733 vs. control group €11,941; 95% CI: 10,701-13,130; mean difference €136). The cost of preventing one case of POD with the music intervention was €415 for the time horizon of the primary admission.

Considering the potential reduction in POD and the comparable costs, music appears to be a cost-effective intervention for preventing POD in elderly hip fracture patients.