Delirium, Cytochrome P-450 Enzyme System
Conditions
Brief summary
Objectives: 1. To examine whether patients with delirium have higher prevalence of cytochrome-P450 abnormalities compared to patients without delirium. 2. To examine whether the severity of delirium is related to a specific cytochrome P450 genotype. 3. To examine the persistence of delirium at 6-8 weeks stratified by presence of cytochrome p450 abnormalities 4. To examine whether delirium persistence is impacted by types of medications administered during their hospital stay.
Detailed description
Delirium is a costly and devastating illness affecting older patients in the hospital. Its prevalence increases as patients get older and sicker. There is scientific evidence that delirium affects cognitive function for a prolonged period of time and in many cases irreversibly. The economic burden on health care and emotional burden on the caregivers of patients with delirium is tremendous. We think that our study may contribute to developing prevention strategies for delirium in the hospital. We propose genetic testing of older patients to determine their ability to metabolize commonly used medications in the hospital. This will give medical professionals and pharmacists an ability to adjust dosages of medications based on the patient's genetic profile.
Interventions
DIAGNOSTIC_TESTCytochrome P450 test
Blood samples will be drawn for cytochrome P450 testing.
Sponsors
Wake Forest University Health Sciences
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
1. Patients age 18 and older admitted to the ALGH (Advocate Lutheran General Hospital) rehabilitation unit 2. One or more of the Following Principle Diagnosis: Principle stroke diagnosis Principle Cardiac-Post cardiac surgery Principle Spinal surgery 3. Non-English speakers are not anticipated. However, there is an available interpreter services already on the unit and this interpreter's services will be utilized. https://www.languageline.com/ However, we will utilize that AHC IRB approved short forms if a potential subject presents itself.
Exclusion criteria
1. Stroke patients with any diagnosed aphasia 2. Spinal surgery, as a result of trauma 3. Pregnant women 4. Prisoners 5. Patients with dementia (score of greater than 3.3 on short IQCODE questionnaire) (Long Term Cognitive Impairment after Critical Illness, NEJM, 2013, Pandharipande et al.) 6. Patients with cirrhosis and liver failure 7. Patients with renal failure requiring dialysis 8. Recent blood transfusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| • Rates of cytochrome P450 in cases (delirium patients) compared to controls (non-delirium patients). | 2 years | Statistical Analysis Plan: Descriptive statistics will be presented as mean ± SD for continuous variables and percentage/count for dichotomous/categorical variables. Chi-square test and t-test will be used to compare distribution of variables of interest between the two groups. Logistic regression analysis will be performed to estimate the risk of PEP while adjusting for all potential confounding factors. |
Countries
United States
Outcome results
None listed