Prevention of Postoperative Delirium After Acute Surgery

NCT ID: NCT04857125

Last Updated: 2021-04-23

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

476 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-12

Study Completion Date

2022-03-31

Brief Summary

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The aim of this trial is to evaluate the implementation and effect of an evidence based, multicomponent intervention on postoperative delirium, when fast implemented throughout the patients stay in hospital before, during and after acute surgery in a risk population, the primary outcome being frequency of patients with positive Confusion Assessment Method (CAM) score.

The hypothesis is that the frequency of postoperative delirium will be reduced after implementation of the preventive interventions.

Detailed Description

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Conditions

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Postoperative Delirium

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
The statistician will be blinded from the groups, when assessing the primary outcome.

Study Groups

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Multicomponent intervention

Pre-, intra- and postoperative interventions applied using the Fast-IM method.

Group Type ACTIVE_COMPARATOR

Patient interventions

Intervention Type OTHER

The multicomponent intervention consists of several elements regarding avoidance of specific pre-medications and optimising the patients condition before surgery (reducing fasting and fluid-fasting time).

Per-operative focus on using bispectral index (BIS) guided anaesthesia, Total intravenous anaesthesia (TIVA) as first choice, pain-and PONV (postoperative nausea and vomiting) prophylaxis and treatment.

Postoperative focus on: Reducing indwelling catheters, Fluid (p.o. or IV), Nutrition, Mobilisation, Sleep, Non-pharmacological interventions (Shielding, involving of relatives, orientation, optimizing of senses)

Staff education

Intervention Type OTHER

Staff will be educated for at least 1-2 hours. Anaesthesiologist and nurse anaesthetists will receive a brush up on the use of bispectral index (BIS) and the intervention elements that are implemented and monitored. Staff in the PACU, as well as staff in the surgery wards, will be educated in postoperative delirium, learning to identify symptoms of delirium and how to use the screening tool CAM.

Standard care

Patients are receiving standard care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Patient interventions

The multicomponent intervention consists of several elements regarding avoidance of specific pre-medications and optimising the patients condition before surgery (reducing fasting and fluid-fasting time).

Per-operative focus on using bispectral index (BIS) guided anaesthesia, Total intravenous anaesthesia (TIVA) as first choice, pain-and PONV (postoperative nausea and vomiting) prophylaxis and treatment.

Postoperative focus on: Reducing indwelling catheters, Fluid (p.o. or IV), Nutrition, Mobilisation, Sleep, Non-pharmacological interventions (Shielding, involving of relatives, orientation, optimizing of senses)

Intervention Type OTHER

Staff education

Staff will be educated for at least 1-2 hours. Anaesthesiologist and nurse anaesthetists will receive a brush up on the use of bispectral index (BIS) and the intervention elements that are implemented and monitored. Staff in the PACU, as well as staff in the surgery wards, will be educated in postoperative delirium, learning to identify symptoms of delirium and how to use the screening tool CAM.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients aged 40 or above.
* Patients scheduled for acute abdominal or orthopaedic surgery in general anaesthesia with an expected duration of 30 minutes or more.
* Patients who are scheduled for surgery within 72 hours of hospital admission.
* Patients who are expected to stay in hospital for 24 hours or more.

Exclusion Criteria

* Patients screened CAM positive before surgery.
* Patients who have already been included in the study
* Patients unable to speak and read Danish.
* Inability to provide consent.
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bispebjerg Hospital

OTHER

Sponsor Role lead

Responsible Party

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Sine Eriksen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christian Meyhoff, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Copenhagen

Locations

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Bispebjerg and Frederiksberg Hospital

Copenhagen, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Sine Eriksen, Cand. Cur.

Role: CONTACT

+ 45 51920075

Facility Contacts

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Role: primary

Other Identifiers

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H-20067775

Identifier Type: -

Identifier Source: org_study_id

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