Clinical effectiveness of delirium risk stratification with multimodal sleep interventions in postoperative orthopedic care
WANG Yalan
GAO Lin
Abstract：Objective To evaluate the preventive effectiveness of risk stratification combined with a multimodal sleep interventions on postoperative delirium in orthopedic patients.Methods A prospective randomized controlled trial was conducted,110 patients from Nanjing Medical University Affiliated Suzhou Hospital undergoing surgery for multiple fractures were randomly assigned to an observation group(n=55)or a control group(n=55).The observation group received individualized multimodal sleep interventions(pharmacotherapy,environmental optimization,cognitive training)based on preoperative risk stratification(high-risk,medium-risk,low-risk),while the control group received routine care.Primary outcomes were delirium incidence,duration,and sleep quality.Results The delirium incidence in the observation group was 16.4%(9/55),significantly lower than 34.5%(19/55)in the control group(P=0.016).Delirium duration was shorter in the observation group((24.5±6.8)h vs.(38.2±9.1)h,P<0.001)).Sleep quality(RCSQ:(7.6±1.2)vs.(5.3±1.5))and comfort scores((8.1±1.0)vs.(6.2±1.3))swere significantly better in the observation group(all P<0.001).Daily nursing time was longer in the observation group((28.5±4.3)min/d vs.(12.1±2.7)min/d).Conclusions Preoperative risk stratification combined with a multimodal sleep interventions effectively reduces the incidence and duration of postoperative delirium and improves sleep quality and comfort in patients after major orthopedic surgery,supporting its clinical applicability.
Keywords：OrthopedicsPostoperative deliriumRisk stratificationMultimodal sleep intervention
Publication Date：2026-01-20
Online Publishing Date：2026-01-29(First online date of this platform, not the publication date of the document)
Pages：5( 57-61 )