Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized
Abstract Objective Delirium in older emergency department (ED) adults is associated with poorer long‐term physical function and cognition. We sought to evaluate if the time to and intensity of physical and/or occupational therapy (PT/OT) are associated with the duration of ED delirium into hospitali...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12857 |
| _version_ | 1797843818307911680 |
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| author | James O. Jordano Eduard E. Vasilevskis Maria C. Duggan Sarah A. Welch John F. Schnelle Sandra F. Simmons E. Wesley Ely Jin H. Han |
| author_facet | James O. Jordano Eduard E. Vasilevskis Maria C. Duggan Sarah A. Welch John F. Schnelle Sandra F. Simmons E. Wesley Ely Jin H. Han |
| author_sort | James O. Jordano |
| collection | DOAJ |
| description | Abstract Objective Delirium in older emergency department (ED) adults is associated with poorer long‐term physical function and cognition. We sought to evaluate if the time to and intensity of physical and/or occupational therapy (PT/OT) are associated with the duration of ED delirium into hospitalization (ED delirium duration). Methods This is a secondary analysis of a prospective cohort study conducted from March 2012 to November 2014 at an urban, academic, tertiary care hospital. Patients aged ≥65 years presenting to the ED and who received PT/OT during their hospitalization were included. Days from enrollment to the first PT/OT session and PT/OT duration relative to hospital length of stay (PT/OT intensity) were abstracted from the medical record. ED delirium duration was defined as the duration of delirium detected in the ED using the Brief Confusion Assessment Method. Data were analyzed using a proportional odds logistic regression adjusted for multiple variables. Adjusted odds ratios (ORs) were calculated with 95% confidence intervals (95%CI). Results The median log PT/OT intensity was 0.5% (interquartile range [IQR]: 0.3%, 0.9%) and was associated with shorter delirium duration (adjusted OR, 0.39; 95% CI, 0.21–0.73). The median time to the first PT/OT session was 2 days (IQR: 1, 3 days) and was not associated with delirium duration (adjusted OR, 1.02; 95% CI, 0.82–1.27). Conclusion In older hospitalized adults, higher PT/OT intensity may be a useful intervention to shorten delirium duration. Time to first PT/OT session was not associated with delirium duration but was initiated a full 2 days after the ED presentation. |
| first_indexed | 2024-04-09T17:12:07Z |
| format | Article |
| id | doaj.art-fd3ef308e47540ec946e872b7ae38b57 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-09T17:12:07Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-fd3ef308e47540ec946e872b7ae38b572023-04-20T05:51:41ZengWileyJournal of the American College of Emergency Physicians Open2688-11522023-02-0141n/an/a10.1002/emp2.12857Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalizedJames O. Jordano0Eduard E. Vasilevskis1Maria C. Duggan2Sarah A. Welch3John F. Schnelle4Sandra F. Simmons5E. Wesley Ely6Jin H. Han7Vanderbilt University School of Medicine Nashville Tennessee USADepartment of Medicine, Section of Hospital Medicine Vanderbilt University Medical Center Nashville Tennessee USAGeriatric Research, Education, and Clinical Center (GRECC) Tennessee Valley Healthcare System Nashville Tennessee USAGeriatric Research, Education, and Clinical Center (GRECC) Tennessee Valley Healthcare System Nashville Tennessee USADepartment of Medicine, Division of Geriatric Medicine Vanderbilt University Medical Center Nashville Tennessee USADepartment of Medicine, Division of Geriatric Medicine Vanderbilt University Medical Center Nashville Tennessee USAGeriatric Research, Education, and Clinical Center (GRECC) Tennessee Valley Healthcare System Nashville Tennessee USAGeriatric Research, Education, and Clinical Center (GRECC) Tennessee Valley Healthcare System Nashville Tennessee USAAbstract Objective Delirium in older emergency department (ED) adults is associated with poorer long‐term physical function and cognition. We sought to evaluate if the time to and intensity of physical and/or occupational therapy (PT/OT) are associated with the duration of ED delirium into hospitalization (ED delirium duration). Methods This is a secondary analysis of a prospective cohort study conducted from March 2012 to November 2014 at an urban, academic, tertiary care hospital. Patients aged ≥65 years presenting to the ED and who received PT/OT during their hospitalization were included. Days from enrollment to the first PT/OT session and PT/OT duration relative to hospital length of stay (PT/OT intensity) were abstracted from the medical record. ED delirium duration was defined as the duration of delirium detected in the ED using the Brief Confusion Assessment Method. Data were analyzed using a proportional odds logistic regression adjusted for multiple variables. Adjusted odds ratios (ORs) were calculated with 95% confidence intervals (95%CI). Results The median log PT/OT intensity was 0.5% (interquartile range [IQR]: 0.3%, 0.9%) and was associated with shorter delirium duration (adjusted OR, 0.39; 95% CI, 0.21–0.73). The median time to the first PT/OT session was 2 days (IQR: 1, 3 days) and was not associated with delirium duration (adjusted OR, 1.02; 95% CI, 0.82–1.27). Conclusion In older hospitalized adults, higher PT/OT intensity may be a useful intervention to shorten delirium duration. Time to first PT/OT session was not associated with delirium duration but was initiated a full 2 days after the ED presentation.https://doi.org/10.1002/emp2.12857deliriumemergency departmentoccupational therapyphysical therapy |
| spellingShingle | James O. Jordano Eduard E. Vasilevskis Maria C. Duggan Sarah A. Welch John F. Schnelle Sandra F. Simmons E. Wesley Ely Jin H. Han Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized Journal of the American College of Emergency Physicians Open delirium emergency department occupational therapy physical therapy |
| title | Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| title_full | Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| title_fullStr | Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| title_full_unstemmed | Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| title_short | Effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| title_sort | effect of physical and occupational therapy on delirium duration in older emergency department patients who are hospitalized |
| topic | delirium emergency department occupational therapy physical therapy |
| url | https://doi.org/10.1002/emp2.12857 |
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