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November 4, 2022Medicine5 citationsOpen Access

Impact of early mobilization on the duration of delirium in elderly hospitalized patients: A retrospective cohort pilot study

SASatoshi AnadaMIMiho IigayaMTMegumi Takahashi

Key Result

Early mobilization, specifically sitting on the bed within one day, significantly shortened the median duration of delirium to 4.0 days compared to 8.0 days with delayed mobilization in elderly inpatients.

Study Design

Type

Cohort (n=45)

Multicenter

No

Structured PICO

Does early mobilization reduce the duration of delirium in elderly hospitalized patients with delirium?

P
Population
45 community-dwelling older adults aged ≥75 years (mean age 84.5, 48.9% female) admitted to a single center in Japan who developed delirium during hospitalization.
I
Intervention
Early mobilization (sitting on the bed within 1 day, wheelchair use within 1 day, or walking within 4 days)
C
Comparator
Delayed mobilization (time interval greater than 50th percentile for mobilization start)
O
Outcome
Duration of delirium

Early mobilization, specifically sitting on the bed or using a wheelchair within one day, significantly shortens the duration of delirium in elderly hospitalized patients.

Main Result

Absolute Event Rate: 4% vs 8%

p-value: p=0.013

Limitations

  • Retrospective pilot study with a relatively small sample size
  • Univariate analysis does not exclude the possible influence of confounding factors
  • Did not assess severity of delirium, nonpharmacological treatment, and ADL level before hospitalization
  • Duration of delirium may be influenced by other factors not assessed (severity of delirium, nonpharmacological treatment, ADL level before hospitalization)

Abstract

Development of delirium during hospitalization impairs the activities of daily living in elderly hospitalized patients. In clinical practice, early mobilization from bed is recommended to reduce delirium incidence and hospitalization stay. However, the effects of early mobilization on elderly inpatients with delirium have not been established yet. The aim of this study was to investigate the association between early mobilization and the duration of delirium in elderly inpatients with delirium. This retrospective cohort pilot study examined 45 participants (23 males, 22 females; mean age: 84. 5 ± 6. 6 years), who developed delirium during hospitalization. Of the participants, 28 were surgically treated and 17 were non-surgically treated. We classified early or delayed mobilization based on the median number of days until the start of mobilization and compared after propensity score matching to adjust for baseline characteristics. Additionally, we examined the correlation between the number of days until the start of mobilization and the duration of delirium. The duration of delirium was significantly shorter in the early mobilization group, particularly in terms of sitting on the bed and wheelchair use than that in the delayed mobilization group median: 4. 0 interquartile range (IQR): 2. 0-6. 0 vs 8. 0 IQR: 7. 0-14. 5 days, P =. 013; median: 3. 0 IQR: 2. 0-5. 5 vs 11. 0 IQR: 7. 5-14. 5 days, P =. 004, respectively. Moreover, the duration of delirium significantly positively moderate correlated with the time until the start of sitting on the bed and wheelchair use (Spearman r = 0. 527; P =. 012, Spearman r = 0. 630; P =. 002, respectively). The results of this study suggest that early mobilization from sitting on the bed or wheelchair use after hospitalization or surgery may shorten the duration of delirium. Because the sample size of this pilot study is small, careful interpretation is needed, and further research is warranted.

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Cite This Study

Anada et al. (2022) conducted a cohort in Delirium (n=45). Early mobilization (sitting on bed within 1 day) vs. Delayed mobilization (≥2 days) was evaluated on Duration of delirium (days) (p=0.013). Early mobilization, specifically sitting on the bed within one day, significantly shortened the median duration of delirium to 4.0 days compared to 8.0 days with delayed mobilization in elderly inpatients.

synapsesocial.com/papers/6a185da01ca866914fc98cf2https://doi.org/10.1097/md.0000000000031641
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Also Consider

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  1. 1Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline2011 · 370 citations
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