Postoperative Delirium
Conditions
Keywords
Postoperative delirium, elderly, prevention, stepped wedge design, healthcare workers
Brief summary
Postoperative delirium is common in the elderly and is associated with a significant increase in mortality, complications, length of hospital stay and admission in long care facility. Several interventions have proved their effectiveness to prevent it but their combination within a multifaceted intervention needs to be assessed using rigorous methodology based on randomized study design. CONFUCIUS trial aims to measure the impact of a multifaceted program on the prevention of postoperative delirium in elderly.
Interventions
BEHAVIORALMultifaceted prevention program HELP(Hospital Elder Life Program)
* A. Structured geriatric consultation will be performed by geriatricians of the MGT(Mobile Geriatric Teams) before surgery, including clinical examination and geriatric assessment * B. All members of medical and nursing staffs will attend a two hours training session performed by the MGTs and HELP(Hospital Elder Life Program) will be implemented in the surgical wards * C. On a quarterly basis, all members of medical and nursing staffs and MGTs will gathered to analyze medical records of patients having experienced a postoperative delirium.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
75 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male or female subject aged over 75 years * Admission for a scheduled surgery (i.e. all oncologic digestive surgery , ureterostomy, nephrectomy or cystectomy, total hip or knee replacement) * Participation agreement
Exclusion criteria
* Patients with a progressive and/or poorly managed psychiatric pathology (patients with stabilized depression could be included in the study)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative delirium rate within 7 days after surgery | 7 days after surgery |
Secondary
| Measure | Time frame |
|---|---|
| Mean delirium intensity within 7 days after surgery | 7 days after surgery |
| Length of hospital stay | Hospital discharge |
| Postoperative complications 30 days after surgery incidence | 30 days after surgery |
| Mortality 6 months after surgery | 6 months after surgery |
| Feasibility of the multidisciplinary prevention program | 24 months |
Countries
France
Outcome results
None listed