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


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.

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Título de la Revista: JOURNAL OF CRITICAL CARE
Volumen: 37
Página de inicio: 85
Página final: 90
Idioma: Ingles