Dr Lara Kimmel1,2, Mrs Melissa Webb1,2, Ms Jade Glascott1, Ms Katherine Muller1, Dr Margot Lodge1,2
1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia
Biography:
Lara is a clinical and research physiotherapist who has worked at the Alfred in Melbourne for over 25 years. She is the Allied Health Team Leader for the trauma team, completed her PhD in 2016 and has over 50 peer reviewed publications.
Lara is also currently the CI for HIPSTER, a multi-centre RCT funded by the MRFF investigating intensive therapy following hip fracture.
Abstract:
Frailty in the trauma patient population is associated with elongated length of stay and poorer progression within the hospital setting. It is also associated with increased hospital acquired complications including delirium. The aim of this study was to determine if early and intensive therapy in the acute hospital for patients with frailty is associated with a reduction in delirium.
Methods:
Data were collected on all patients with frailty admitted to the trauma ward at The Alfred in Melbourne from June 2023 until Nov 30, 2024. From April 1, 2024, all patients with frailty were targeted to receive early intervention by the Allied Health team, including interventions for physical and psychological well-being. The occasions of service and time spent with patients were compared with the main outcome being rates of delirium for patients pre and post intervention.
Results:
There were 284 patients in the pre intervention group and 249 in the intervention group. There was a significant increase in the median occasions of service [13 (7, 22); 17 (9, 28) p<0.001] and median time spent [8.2(4.1, 14) hrs; 10.9 (6, 17.5) hrs p<0.001] with the patients in the intervention time period compared to baseline. The rate of delirium in the baseline period was 18.3 % which reduced to 16.4% following introduction of the targeted therapy.
Conclusion:
Preliminary results show that the introduction of targeted early, multidisciplinary intervention for patients with frailty in the acute hospital can lead to a reduction in rates of in-hospital delirium.