Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: A pilot randomized clinical trial

Alvarez, Evelyn A; Garrido, Maricel; Tobar, Eduardo; Prieto, Stephanie; Gonzalez, Francisco; Briceño, Constanza; Vergara, Sebastian

Keywords: Delirium, Elderly, Occupational Therapy, Intensive Care Units, functional outcomes

Abstract

Purpose: Delirium has negative consequences such as increased mortality, hospital expenses and decreased cog- nitive and functional status. This research aims to determine the impact of occupational therapy intervention in duration, incidence and severity of delirium in elderly patients in the intensive care unit; secondary outcome was to assess functionality at hospital discharge. Methods: This is a pilot randomized clinical trial of patients without mechanical ventilation for 60 years. Patients were assigned to a control group that received standard strategies of prevention (n = 70) or to an experimental group that received standard strategies plus occupational therapy twice a day for 5 days (n = 70). Delirium was valued with Confusion Assessment Method and Delirium Rating Scale, and functional outcomes at discharge with Functional Independence Measure, Hand Dynamometer, and Mini-Mental State Examination. Results: A total of 140 participants were recruited. The experimental group had lower duration (risk inci- dence ratios, 0.15 [P = .000; 95% confidence interval, 0.12-0.19] vs 6.6 [P = .000, 95% confidence interval, 5.23-8.3]) and incidence of delirium (3% vs 20%, P = .001), and had higher scores in Motor Functional Inde- pendence Measure (59 vs 40 points, P b .0001), cognitive state (MMSE: 28 vs 26 points, P b .05), and grip strength in the dominant hand (26 vs 18 kg, P b .05), compared with the control group. Conclusions: Occupational therapy is effective in decreasing duration and incidence of delirium in nonventilated elderly patients in the intensive care unit and improved functionality at discharge.

Más información

Título de la Revista: JOURNAL OF CRITICAL CARE
Volumen: 37
Editorial: W B SAUNDERS CO-ELSEVIER INC
Página de inicio: 85
Página final: 90
Idioma: Ingles