Impact of a Multifaceted Program to Prevent Postoperative Delirium in the Elderly

Study Overview
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Brief Summary
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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.

Official Title
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CONFUCIUS Study : Impact of a Multifaceted Program to Prevent Postoperative Delirium in the Elderly

Conditions
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Postoperative Delirium

Intervention / Treatment
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* Behavioral: Multifaceted prevention program HELP(Hospital Elder Life Program)


Participation Criteria
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Eligibility Criteria
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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)

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: multifaceted prevention program<br> | Behavioral: Multifaceted prevention program HELP(Hospital Elder Life Program)<br>* 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.<br>|
| No Intervention: usual care<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative delirium rate within 7 days after surgery |  | 7 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative delirium, elderly, prevention, stepped wedge design, healthcare workers