Post Operative Cognitive Dysfunction

NCT ID: NCT03067259

Last Updated: 2023-02-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-20

Study Completion Date

2022-03-01

Brief Summary

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The objective of this study will be to estimate the incidence of postoperative cognitive dysfunction (DCPO) in patients over 65 years of age, undergoing surgical / anesthetic procedures and in patients who will not undergo surgical / anesthetic. The patients will be taken from the Hospital Italiano de Buenos Aires.

Detailed Description

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Prospective Study The objective of this study will be to estimate the incidence of Post Operative Cognitive Dysfunction (POCD) in patients over 65 years of age, undergoing surgical / anesthetic procedures and in patients who will not undergo surgical / anesthetic. The patients will be taken from the Hospital Italiano de Buenos Aires.

The population of the present study will be constituted by patients belonging to the HIBA Health Plan. It comprises patients who will not undergo any surgical / anesthetic act (Control Group) and those who will undergo sedation for diagnostic procedure or some surgical / anesthetic process (Exposure Group).

All patients will be tested, the day of signing the Informed Consent (IC), which will serve as an exclusion criterion.

Patients in the Exposure Group who signed the consent will be evaluated on five occasions: up to the day before the surgical / anesthetic act, on the day of the surgical / anesthetic event, 7 days (CAM - If the patient is hospitalized this test will do the test personally if the patient is discharged, the test will be done by telephone), 3 months later and a year after the procedure (for the latter two patients will be asked to attend the Hospital in time). Trained and trained personnel will be in charge of taking the test (which last approximately 1 hour). The battery of tests (detailed below) aims to determine if there is a cognitive decline, to estimate and compare it among the participants of this study.

Patients in the control group will be evaluated on 2 occasions only, a first evaluation on the day the patient and the researchers arrange and then, 12 months from that date.

Conditions

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Postoperative Complications

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Control Group

It comprises patients who will not undergo any surgical / anesthetic act

Group Type NO_INTERVENTION

No interventions assigned to this group

Exposure Group

It comprises those patients that will undergo sedation for diagnostic procedure or some surgical / anesthetic process

Group Type OTHER

Exposure Group

Intervention Type OTHER

Surgeries of high or low impact. They could be local , regional o general anesthesia; sedation or a combination of both.

Interventions

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Exposure Group

Surgeries of high or low impact. They could be local , regional o general anesthesia; sedation or a combination of both.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

or surgical / anesthetic and sedation.

* Patients who have not been exposed in the last 12 months to any of the cases mentioned above.
* Patients with scheduled surgeries will be included, both in the outpatient clinic and with requirements for hospitalization in the floor or in closed units (ICU, UC, etc.), and patients with diagnostic studies or therapeutic procedures requiring anesthesia for their performance by the other.
* Patients will be included with absence of anesthetic or surgical / anesthetic act and sedation in the last 12 months.
* Patients with complete primary schooling (6 years) will be included.

Exclusion Criteria

* Negative to participate or manage Informed Consent
* MoCa (≤ 26)
* Previous diagnosis of dementia
* Psychosis
* Depression. (GDS Yesavage\> 5)
* Toxic Substance abuse of Alcohol according to DSM4 Psychoactive Substances.

• Use of Illicit drug
* The presence of any congenital or acquired disease or injury that could generate cognitive deficit. (Whether psychiatric, neurological, or metabolic)
* Previous neurosurgery.
* Language barriers.
* Decreased marked visual or auditory acuity that enable from performing the study tests.
* Patients receiving antipsychotics, opioids, anticholinergics or patients who may have varied the benzodiazepines doze or other psychoactive drugs in the last 30 days.
* Patient with cancer disease and life expectancy less than 1 year ( patients will be evaluated from the medical point of view from the records of clinical history according to tumor type, extent,etc.)
* Patients undergoing emergency surgery.
* Patients who have received anesthesia in the past 12 months
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Italiano de Buenos Aires

OTHER

Sponsor Role lead

Responsible Party

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FRANCISCO CARLOS BONOFIGLIO

Anesthesiology Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Francisco FB Bonofiglio, PHD

Role: PRINCIPAL_INVESTIGATOR

Hospital Italiano de Buenos Aires

Locations

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Hospital Italiano de Buenos Aires

Buenos Aires, , Argentina

Site Status

Countries

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Argentina

References

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BEDFORD PD. Adverse cerebral effects of anaesthesia on old people. Lancet. 1955 Aug 6;269(6884):259-63. doi: 10.1016/s0140-6736(55)92689-1. No abstract available.

Reference Type BACKGROUND
PMID: 13243706 (View on PubMed)

Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, Rabbitt P, Jolles J, Larsen K, Hanning CD, Langeron O, Johnson T, Lauven PM, Kristensen PA, Biedler A, van Beem H, Fraidakis O, Silverstein JH, Beneken JE, Gravenstein JS. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998 Mar 21;351(9106):857-61. doi: 10.1016/s0140-6736(97)07382-0.

Reference Type BACKGROUND
PMID: 9525362 (View on PubMed)

Rasmussen LS, Johnson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, Jolles J, Papaioannou A, Abildstrom H, Silverstein JH, Bonal JA, Raeder J, Nielsen IK, Korttila K, Munoz L, Dodds C, Hanning CD, Moller JT; ISPOCD2(International Study of Postoperative Cognitive Dysfunction) Investigators. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand. 2003 Mar;47(3):260-6. doi: 10.1034/j.1399-6576.2003.00057.x.

Reference Type BACKGROUND
PMID: 12648190 (View on PubMed)

Hudetz JA, Iqbal Z, Gandhi SD, Patterson KM, Hyde TF, Reddy DM, Hudetz AG, Warltier DC. Postoperative cognitive dysfunction in older patients with a history of alcohol abuse. Anesthesiology. 2007 Mar;106(3):423-30. doi: 10.1097/00000542-200703000-00005.

Reference Type BACKGROUND
PMID: 17325499 (View on PubMed)

Price CC, Garvan CW, Monk TG. Type and severity of cognitive decline in older adults after noncardiac surgery. Anesthesiology. 2008 Jan;108(1):8-17. doi: 10.1097/01.anes.0000296072.02527.18.

Reference Type BACKGROUND
PMID: 18156877 (View on PubMed)

Rasmussen LS. Postoperative cognitive dysfunction: incidence and prevention. Best Pract Res Clin Anaesthesiol. 2006 Jun;20(2):315-30. doi: 10.1016/j.bpa.2005.10.011.

Reference Type BACKGROUND
PMID: 16850780 (View on PubMed)

Spiegel DR, Chen V. A case of postoperative cognitive decline, with a highly elevated C- reactive protein, status post left ventricular assist device insertion: a review of the neuroinflammatory hypothesis of delirium. Innov Clin Neurosci. 2012 Jan;9(1):35-41.

Reference Type BACKGROUND
PMID: 22347689 (View on PubMed)

Krenk L, Rasmussen LS. Postoperative delirium and postoperative cognitive dysfunction in the elderly - what are the differences? Minerva Anestesiol. 2011 Jul;77(7):742-9.

Reference Type BACKGROUND
PMID: 21709661 (View on PubMed)

Other Identifiers

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2813

Identifier Type: -

Identifier Source: org_study_id

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