P1‐270: Modified hospital elder life program improves long‐term cognitive outcomes

Postoperative delirium is common in older patients and can lead poor outcomes. It is unclear whether delirium prevention strategies such as the modified Hospital Elder Life Program (HELP) affect long-term cognitive outcomes. A pre-and postintervention clinical trial. Consecutive patients (N = 179) were enrolled if they had undergone common elective abdominal surgical procedures such as gastrectomy, cholecystectomy, and Whipple surgery. A modified HELP intervention, consisting of early mobilization, nutritional assistance, and cognitive stimulation activities implemented by a trained nurse, was introduced on a surgical ward in May 2008. Patients enrolled before May 2008 received usual care and served as controls (n = 77). Those enrolled after the modified HELP intervention comprised the experimental group (n = 102). Changes in cognitive function measured at admission, discharge, and 3 months afterward were the primary endpoints. Patients in the HELP group did not present delirium while 16.7% of patients in control met the criteria of delirium by hospital discharge. At 3 months afterward, improvement in global cognitive status (measured by the mini-mental state examination) and depressive symptoms (measured by geriatric depression scale) persisted. This in-hospital modified HELP intervention not only effectively reduced older surgical patients' delirium rates by hospital discharge but also improve the 3 months cognitive outcomes afterward.