Aging
Conditions
Keywords
atropinic drugs, confusion, elderly patients
Brief summary
The identification of a high atropine load of treatment received during hospitalization as a predictor of postoperative confusion could have various benefits: * Pharmacoepidemiological: identify factors associated with postoperative confusion * Clinics: by favoring treatments with a low atropine load during anesthesia, the management of patients hospitalized in orthopedics. Similarly, stopping or re-evaluating treatments with a high atropine weight for scheduled surgery is an easy step to take. * Socio-economic: by reducing the costs related to the occurrence of a confusional syndrome (over-treatment, prolonged hospital stay, loss of autonomy, institutionalization of patients...). In total, the present study would improve the daily management of hospitalized patients and the practices of clinicians, by offering a decision-making aid.
Interventions
OTHERData collection
The collection of data will be done by interrogation of the patient and his family / entourage and rereading of medical records
Sponsors
University Hospital, Toulouse
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Admitted to the orthopedic department for surgical management of a fracture of the upper end of the femur in emergency or for the installation of a hip or knee prosthesis * Patient able to understand and respond to the protocol * No opposition to the collection of data of the patient or his / her designee
Exclusion criteria
* Pre-existing confusion to surgery, detected by the CAM scale * Serious or moderate head trauma less than three months old * Removing / installing prosthesis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association between atropine load of medications on the risk of postoperative confusion | up to 7 days | Occurrence of a postoperative confusion syndrome performed by Confusion Assessment Method (CAM) scale once a day. The CAM is a validated scale as a diagnostic scale for confusional syndrome at the patient's bedside with four parts : 1) confusion and fluctuation of symptoms, 2) inattention, 3) disorganization of thought, 4) disorder of consciousness. |
| Atropinic load of drugs | up to 7 days | The DURAN scale is the most recent and most comprehensive atropine load evaluation scale. This scale classifies the evaluated drugs into three categories: no anticholinergic power (atropine weight = 0), low anticholinergic activity (atropine weight = 1), high atropinic power (atropine weight = 3). All drugs received by the patient during 7 days will be classified with the Duran scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of hospitalization | Up to discharge, an average of ten days | Number of days of hospitalization (days) between surgery and discharge. Association between atropinic load of drugs and duration of hospitalization will be evaluated. |
| Autonomy | Month 3 | Description of autonomy of the patient at three months of surgery evaluated by the Activity Daily Living scale (ADL). The ADL scale evaluates activities of daily living: washing, dressing, going to the bathroom, ensuring transfers, continence and food. Each item is rated according to a level of dependence: independent (1 point), with assistance (0.5 points), unable to achieve (0 points). A total of 6 points indicates a total autonomy, and 0 a total dependency. |
| Cognitive dysfunction | baseline | Appearance postoperative cognitive dysfunction by the Mini Mental State (MMS). the total score of MMS wil be collected. |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORVincent Minville
University Hospital, Toulouse
Outcome results
None listed