TY - JOUR
T1 - Effect of perioperative music on delirium after hip fracture operations (MCHOPIN)
T2 - a multicentre randomised clinical trial in Dutch hospitals
AU - Dirven, Thomas L.A.
AU - Fu, Victor X.
AU - MCHOPIN Collaborators
AU - Becker, Antonia S.
AU - Andrinopoulou, Eleni Rosalina
AU - Kalisvaart, Kees
AU - Jeekel, Johannes
AU - Klimek, Markus
AU - Verhofstad, Michael H.J.
AU - van der Velde, Detlef
AU - Slegers, Leonie
AU - Haverlag, Robert
AU - Haumann, Johan
AU - Heemskerk, Johan
AU - van der Elst, Maarten
AU - Hartholt, Klaas
AU - van Cosburgh, Jurjan
AU - Wörner, Lisa
AU - Greeven, Alexander
AU - Aukema, Tjeerd S.
AU - Rad, Mandana
AU - Willems, Siem
AU - Romsom, Jesse
AU - Leijnen, Michiel
AU - Hoencamp, Rigo
AU - ter Riet, Stefan
AU - van Schie, Peter
AU - Spierenburg, Geert
AU - van der Bij, Gerben
AU - van Noort, Arthur
AU - Boom, Annemieke
AU - van Duijvenvoorde, Erik
AU - van Boekel, Anniek
AU - Berger, Isabel
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
PY - 2025/8/28
Y1 - 2025/8/28
N2 - Objectives:Postoperative delirium is a frequent complication with possible detrimental consequences in older hip fracture patients. Music interventions are promising, with positive effects on risk factors for delirium. This study aimed to assess the impact of perioperative music on postoperative delirium in older hip fracture patients. Design: Prospective randomised controlled trial. Setting:Multicentre study, performed in six participating hospitals in the Netherlands. Participants: Eligibility criteria included patients aged ≥65 years with an acute hip fracture requiring surgery and documented informed consent. 449 patients were randomised, with a median age of 81 years (IQR 74–87), including 287 women (63.9%). Interventions:Music group participants received the intervention preoperatively, intraoperatively, and postoperatively twice a day for 30 min. The control group received standard-of-care, supplemented by headphones without music intraoperatively for equal noise reduction in both groups. Primary and secondary outcome measures:The primary outcome was delirium diagnosis (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), assessed by a geriatrician. Associations were analysed using regression models. Secondary outcomes included: Delirium Observational Score, anxiety, pain and postoperative complications. Results: Intention-to-treat analysis showed no statistically significant decrease of delirium in the music group, compared with the control group (OR 0.685 (95% CI 0.378 to 1.242); p=0.21). However, in the modified-intention-to-treat analysis, a significant decrease in postoperative delirium was observed (OR 0.478 (95% CI 0.245 to 0.933); p=0.028), which is substantiated by a logistic regression (OR 0.43 (95 % CI 0.19 to 0.98); p=0.045). Also, more postoperative complications were observed in the control group (93 (43.3%); 66 (32.7); p=0.026) in this analysis. The intervention was associated with high patient satisfaction and no adverse events. Conclusions:This study suggests a positive effect of music interventions on postoperative delirium, which provides additional evidence for considering the implementation of these interventions in hip fracture care.
AB - Objectives:Postoperative delirium is a frequent complication with possible detrimental consequences in older hip fracture patients. Music interventions are promising, with positive effects on risk factors for delirium. This study aimed to assess the impact of perioperative music on postoperative delirium in older hip fracture patients. Design: Prospective randomised controlled trial. Setting:Multicentre study, performed in six participating hospitals in the Netherlands. Participants: Eligibility criteria included patients aged ≥65 years with an acute hip fracture requiring surgery and documented informed consent. 449 patients were randomised, with a median age of 81 years (IQR 74–87), including 287 women (63.9%). Interventions:Music group participants received the intervention preoperatively, intraoperatively, and postoperatively twice a day for 30 min. The control group received standard-of-care, supplemented by headphones without music intraoperatively for equal noise reduction in both groups. Primary and secondary outcome measures:The primary outcome was delirium diagnosis (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), assessed by a geriatrician. Associations were analysed using regression models. Secondary outcomes included: Delirium Observational Score, anxiety, pain and postoperative complications. Results: Intention-to-treat analysis showed no statistically significant decrease of delirium in the music group, compared with the control group (OR 0.685 (95% CI 0.378 to 1.242); p=0.21). However, in the modified-intention-to-treat analysis, a significant decrease in postoperative delirium was observed (OR 0.478 (95% CI 0.245 to 0.933); p=0.028), which is substantiated by a logistic regression (OR 0.43 (95 % CI 0.19 to 0.98); p=0.045). Also, more postoperative complications were observed in the control group (93 (43.3%); 66 (32.7); p=0.026) in this analysis. The intervention was associated with high patient satisfaction and no adverse events. Conclusions:This study suggests a positive effect of music interventions on postoperative delirium, which provides additional evidence for considering the implementation of these interventions in hip fracture care.
UR - https://www.scopus.com/pages/publications/105014531145
U2 - 10.1136/bmjopen-2024-095819
DO - 10.1136/bmjopen-2024-095819
M3 - Article
C2 - 40876886
AN - SCOPUS:105014531145
SN - 2044-6055
VL - 15
JO - BMJ open
JF - BMJ open
IS - 8
M1 - e095819
ER -