title: Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation.
abstract: OBJECTIVE
  To evaluate the effect of inpatient geriatric consultation teams (IGCTs), which have been introduced to improve the quality of care of older persons hospitalized on nongeriatric wards, on delirium and overall cognitive functioning in older adults with hip fracture.
  
  
  METHODS
  Controlled trial.
  
  
  METHODS
  Two trauma wards in a university hospital setting.
  
  
  METHODS
  One-hundred seventy-one people with hip fracture aged 65 and older assigned to a multidisciplinary geriatric intervention (n = 94) or usual care (n = 77).
  
  
  METHODS
  Incidence and duration of delirium were measured using the Confusion Assessment Method, severity of delirium using the Delirium Index, and cognitive status using the 12-item Mini-Mental State Examination.
  
  
  RESULTS
  Significantly more controls (53.2%; n = 41) than intervention group participants (37.2%; n = 35; P = .04; odds ratio (OR) = 1.92, 95% confidence interval (CI) = 1.04-3.54) were delirious at any point after surgery. No significant difference was found between the groups for duration or severity of delirium episodes. The proportion of participants with cognitive decline at discharge was higher in controls than in those assigned to geriatric intervention (38.7% vs 22.6%; P = .02; OR = 2.16, 95% CI = 1.10-4.24).
  
  
  CONCLUSIONS
  Delirium episodes and cognitive decline during hospitalization were found to be common in older adults with hip fracture, as expected, but an IGCT intervention reduced the incidence of these adverse outcomes. In participants who developed delirium, a geriatric consultation had no effect on severity or duration of the delirium episode.
authors.affiliation: Center for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: Deschodt
authors.forename: Tom
authors.initials: T
authors.lastname: Braes
authors.forename: Johan
authors.initials: J
authors.lastname: Flamaing
authors.forename: Elke
authors.initials: E
authors.lastname: Detroyer
authors.forename: Paul
authors.initials: P
authors.lastname: Broos
authors.forename: Patrick
authors.initials: P
authors.lastname: Haentjens
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Koen
authors.initials: K
authors.lastname: Milisen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D003693:Delirium / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data*