Heart Failure, Delirium Confusional State
Conditions
Keywords
Heart failure, delirium, older adults
Brief summary
Biomarkers such as Systemic Immune-Inflammation Index (SII) and TG/Glucose Ratio (TyG) have shown promise in predicting delirium, reflecting the roles of inflammation and metabolic disturbances in its pathophysiology. This study aims to compare the predictive value of SII and the TyG ratio among other chemical and physiological biomarkers for diagnosing delirium and detecting its severity in older adults with heart failure. These biomarkers reflect different pathophysiological pathways implicated in delirium, including inflammation, cardiovascular stress, and metabolic dysfunction. By evaluating their individual and combined predictive abilities, this research seeks to identify potential tools for early identification of patients at high risk for delirium
Interventions
OTHERComprehensive Geriatric Assessment
multidimensional assessment of cognition, physical, function, mood, social status of the participants
OTHERthe Confusion Assessment Method (CAM test) or CAM-ICU
standardized tool designed to quickly and accurately diagnose delirium by assessing four key features: acute mental change, inattention, and either disorganized thinking or altered consciousness. The original CAM is used for communicative patients on general wards, relying on conversation, while the CAM-ICU is adapted for critically ill, often non-verbal patients in the ICU, using non-verbal tasks and sedation scales. By providing a rapid, reliable method for identifying this often-missed condition, both tools trigger crucial medical interventions, helping to mitigate delirium's serious risks, including longer hospital stays, long-term cognitive decline, and increased mortality.
OTHERDelirium Rating Scale - Revised-98
The Delirium Rating Scale-Revised-98 (DRS-R-98) is a standardized, expert-rated clinical tool designed specifically to measure the severity of delirium and help distinguish it from other psychiatric disorders, such as dementia, depression, and schizophrenia. Unlike the CAM/CAM-ICU, which provides a simple yes/no diagnosis, the DRS-R-98 quantifies how severe a patient's delirium is at a given point in time and tracks changes in that severity over the course of the illness
DIAGNOSTIC_TESTblood biomarkers
complete blood count(to obtain systemic inflammatory index) ,triglyceride (TG) and glucose, Liver and kidney function tests and serum electrolytes level
Sponsors
Ain Shams University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Heart failure stage C
Exclusion criteria
1. cognitive impairment 2. Major Neurological Conditions: (e.g., stroke, traumatic brain injury). 3. Hematological diseases that affect platelet, neutrophil, and lymphocyte counts. 4. Cardiogenic Shock 5. Sepsis 6. Ongoing Treatment with Immunosuppressants, or corticosteroids
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the sensitivity and specificity of different biomarkers of delirium in heart failure older patient | Within 24 hours of hospital admission | assess sensitivity and specificity of the systemic inflammatory index (SII), Rate Pressure Product (RPP), and TG/glucose ratio in predicting delirium |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| in hospital morbidity | From enrollment to the hospital discharge about 6 weeks | follow up cohort for possible complications like acute kidney injury, infections, or adverse drug events |
| In hospital mortality | From enrollment to hospital discharge about 6 weeks | cohort follow up throughout hospital course and mortality recorded |
Countries
Egypt
Outcome results
None listed