A 3-protocol program reduces delirium, hospital stay for older surgery patients

When older patients who underwent abdominal surgery received a three-part intervention including nutritional assistance, they were less likely to experience delirium and also had a shorter hospital stay, according to a study in JAMA Surgery.


Researchers conducted a randomized trial of 377 patients over age 65 who underwent elective abdominal surgery in Taiwan and who had an expected length of stay of six days or longer. Of the 377 total patients, 197 received an intervention and 180 received usual care.

The intervention is known as the modified Hospital Elder Life Program and consists of three protocols:

  • Orienting communication, including engaging the patient in conversation
  • Oral care, including brushing teeth, and nutritional assistance, like postoperative dietary education
  • Early mobilization

Just 6.6 percent of patients who received the mHELP intervention experienced postoperative delirium, while 15.1 percent of patients in the control group experienced delirium after surgery. Additionally, mHELP patients had a median length of stay two days shorter than control group patients (12 versus 14 days).

"The key to the effectiveness of the three mHELP components is their consistent and daily application, with high adherence rates," the study's authors concluded. "Medical centers that want to advance postoperative care for older patients might consider mHELP as a highly effective starting point for delirium prevention."

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