Evidence map›Paper›PMID 28538964›Full record

Trial reportJAMA surgery2017

Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial.

Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien and 4 more

4 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 95 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 14 pooled it
16.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01045330 nacompletednot on this map

Effect of the National Taiwan University Hospital Elder Life Program

TypeinterventionalSponsorNational Taiwan University HospitalRan2009 to 2012Enrolled377ConditionsEarly AmbulationArmsa modified NTU-HELP
NCT06054828 narecruitingnot on this mapstarted 2023, after this paper: background citation

Modified Hospital Elder Life Program at Intensive Care Unit: A Stepped-Wedge Cluster Randomized Controlled Trial

TypeinterventionalSponsorNational Taiwan University HospitalRan2023 to 2026Enrolled266ConditionsICU DeliriumArmsmHELP@ICU
NCT06999668 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Prospective Randomized Controlled Trial of VR Cognitive Training in Reducing Postoperative Delirium in Elderly Patients With Cerebral Small Vessel Disease Undergoing Non-Cardiac Surgery

TypeinterventionalSponsorPeking University Third HospitalRan2025 to 2027Enrolled416ConditionsPostoperative Delirium (POD), Cerebral Small Vessel DiseasesArmsVirtual reality cognitive function training, Virtual scene intervention
NCT07370844 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Prospective Randomized Controlled Trial of VR Training to Improve Postoperative Cognitive Function in Elderly Patients With Cerebral Small Vessel Disease Undergoing Non-Cardiac Surgery

TypeinterventionalSponsorPeking University Third HospitalRan2026 to 2027Enrolled240ConditionsCerebral Small Vessel Disease, Postoperative Cognitive FunctionArmsVirtual reality cognitive function training, Virtual scene intervention
3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 14 syntheses or guidelines pooled it, 225 citations in OpenAlex.

  1. Nonpharmacological interventions for preventing delirium in adult patients with cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2018
    Pooled it
  14. Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Review

35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 2 countries.

Cheryl Chia-Hui ChenDepartment of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Hsiu-Ching LiDepartment of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Jin-Tung LiangDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
I-Rue LaiDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Jerry Dwi Trijoyo PurnomoInstitute of Statistics, National Chiao Tung University, Hsinchu, Taiwan.
Yi-Ting YangTaiwan Center for Disease Control, Taipei, Taiwan.
Been-Ren LinDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
John HuangDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ching-Yao YangDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yu-Wen TienDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chiung-Nien ChenDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ming-Tsan LinDepartment of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.
Guan-Hua HuangInstitute of Statistics, National Chiao Tung University, Hsinchu, Taiwan.
Sharon K InouyeDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
National Taiwan University Hospital · TWNational Yang Ming Chiao Tung University · TWBeth Israel Deaconess Medical Center · USCenter for Disease Control · TWNational Taiwan University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceOlder patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS).

objectiveTo examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. DESIGN, SETTING, AND

participantsThis cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012. Consecutive older patients scheduled for elective abdominal surgery with expected LOS longer than 6 days were enrolled, with a recruitment rate of 65.3%. Participants were cluster randomized by room to receive the mHELP or usual care.

interventionsThe intervention (implemented by an mHELP nurse) consisted of 3 protocols administered daily: orienting communication, oral and nutritional assistance, and early mobilization. Intervention group participants received all 3 mHELP protocols postoperatively, in addition to usual care, as soon as they arrived in the inpatient ward and until hospital discharge. Adherence to protocols was tracked daily. MAIN OUTCOMES AND MEASURES: Presence of delirium was assessed daily by 2 trained nurses who were masked to intervention status by using the Confusion Assessment Method. Data on LOS were abstracted from the medical record.

resultsOf 577 eligible patients, 377 (65.3%) were enrolled and randomly assigned to the mHELP (n = 197; mean [SD] age, 74.3 [5.8] years; 111 [56.4%] male) or control (n = 180; mean [SD] age, 74.8 [6.0] years; 103 [57.2%] male) group. Postoperative delirium occurred in 13 of 196 (6.6%) mHELP participants vs 27 of 179 (15.1%) control individuals, representing a relative risk of 0.44 in the mHELP group (95% CI, 0.23-0.83; P = .008). Intervention group participants received the mHELP for a median of 7 days (interquartile range, 6-10 days) and had a shorter median LOS (12.0 days) than control participants (14.0 days) (P = .04). CONCLUSIONS AND RELEVANCE: For older patients undergoing abdominal surgery who received the mHELP, the odds of delirium were reduced by 56% and LOS was reduced by 2 days. Our findings support using the mHELP to advance postoperative care for older patients undergoing major abdominal surgery.

trial registrationclinicaltrials.gov Identifier: NCT01045330.

Indexed as

Elective Surgical ProceduresAbdomenAgedCluster AnalysisDeliriumFemaleGeriatric AssessmentHumansIncidenceLength of StayMalePostoperative CarePostoperative ComplicationsTaiwan

Identifiers

PMID28538964
PMCPMC5710459
OpenAlexW2617563026

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.