Please select the eligibility criteria that correspond to the clinical trial below.
Title: Supporting the Health of Adults Undergoing Orthopedic Surgery During the Recovery Period
Brief Summary: Delirium (acute confusion) is a highly prevalent condition among hospitalized elders with substantial morbidity within the hospital and beyond. Particular patient populations are at high risk for poor outcomes after an episode of delirium. Patients with hip and other long bone fractures are at increased risk of developing delirium (acute confusion) which impedes functional recovery. This is a pilot study to test the tolerability and efficacy of donepezil, a cholinesterase inhibitor medication used commonly in persons with dementia, for the prevention of new or worsening delirium in aged hip and other long-bone fracture patients. Additional purposes involve gathering a small amount of patients' serum to better understand the pathophysiology of delirium in this population.

The purposes of this pilot study are to determine: 1) the safety and tolerability a cholinesterase inhibitor medication) in aged hip and long bone fracture patients, 2) To obtain estimates of subject accrual and preliminary estimates of effect size on the development of new delirium symptoms to allow for planning of a larger, definitive trial, 3) To better understand the underlying causes of delirium by examining whether a measure of blood anticholinergic activity relates to the incidence and persistence of delirium symptoms, and 4) To explore the interaction between anticholinergic activity, donepezil therapy, and delirium symptoms.


Options:
A: Inclusion Criteria:

* Patients scheduled for a non-cardiac surgical procedure of high or intermediate cardiac risk are eligible if they have documented coronary artery disease (CAD) or are at high risk of CAD.

Exclusion Criteria:

* Ongoing medication with sulfonylurea derivatives (unless stopped ≥ 2 days before surgery) or theophylline
* Emergency surgery
* Unstable angina pectoris
* Preoperative hemodynamic instability
* Severe hepatic disease
* Renal insufficiency (creatinine clearance \< 30 ml/min)
* Severe chronic obstructive pulmonary disease (forced expiratory volume in 1 second \[FEV1\] \< 1 litre)
* Absence of written patient consent
B: Inclusion Criteria:

* hip or other long bone fracture undergoing operative repair
* age of 70 years or older
* the ability to communicate effectively in English (including adequate hearing)
* residence within a 50 mile radius of the BIDMC
* life expectancy 6 months or greater
* not currently on cholinesterase inhibitor therapy
* not with known hypersensitivity to cholinesterase inhibitors
* not a previous study participant or refusal

Exclusion Criteria:

* patients with sick sinus syndrome or greater than 1st degree AV block without a pacemaker
* patients with a pathologic fracture due to metastatic cancer
* patients with advanced dementia or total functional dependence.
C: Inclusion Criteria:

* Has undergone surgical repair for a hip fracture
* Has a postoperative Hgb level below 10 g/dL within three days of surgery
* Diagnosis of cardiovascular disease (e.g., coronary artery disease, congestive heart failure, stroke or transient ischemic attack, or peripheral vascular disease) or cardiovascular risk factors (e.g., diabetes mellitus, hypertension, hypercholesterolemia, tobacco use, or creatinine levels greater than 2.0 mg/dL)

Exclusion Criteria:

* Unable to walk prior to hip fracture
* Declines blood transfusions
* Suffered multiple traumas
* Pathologic fracture of the hip due to malignancy
* Clinically recognized acute myocardial infarction within the 30 days prior to study entry
* Previously participated in the trial and fractured the other hip
* Symptoms associated with anemia (e.g., ischemic chest pain) or actively bleeding at the time of randomization
D: Inclusion Criteria:

* Patients with coronary artery disease scheduled for elective CABG
* Patients willing and able to complete the requirements of this study
* Ejection Fraction \> 50%
* EuroSCORE ≤ 8
* men and women \>= 50 yrs
* women without childbearing potential
* ASA Score II-IV

Exclusion Criteria:

* Lack of informed consent
* EuroSCORE \< 8
* MMSE \< 24
* Age \< 50 years
* COPD GOLD \> II, increased need of oxygen
* Renal dysfunction
* Liver function disorders
* Acute coronary syndrome during the last 24 hours; hemodynamic instability
* Requirement of inotropic support
* Off-pump-surgery
* Disabling neuropsychiatric disorders
* History of stroke with residuals
* Hypersensitivity to the study anaesthetics
* Increased intracranial pressure
* Pregnancy and lactation period
* Women of childbearing potential
* Presumed uncooperativeness or legal incapacity
* Participation in a concomitant trial

Answer: B