Description of Therapy Options and Successes in the Long-term Course of Delirium in the Recovery Room - CESARO II

Study Overview
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Brief Summary
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This project is a multicenter pilot project to evaluate the therapeutic success in the long term up to 3 months after a delirium in a recovery room. There is a Europe-wide recommendation for the prevention of postoperative delirium in older patients and the evidence and consensus-based guideline Management of delirium, analgesia and sedation in intensiv care medicine of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) are regularly updated for the detection and treatment of delirium in the intensive care unit. The aim is to evaluate the effects of a systematic delirium screening and the delirium treatment options in the long term in the same way as the current recommendations for the patient cohort of the recovery room.

Official Title
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Description of Therapy Options and Successes in the Long-term Course of Delirium in the Recovery Room - Multicenter Observational Study (CESARO-2)

Conditions
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Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients admitted to the recovery room who have been diagnosed with delirium according to the treating physicians The patient is on a ward in the hospital Age ≥ 18 years Stay in the recovery room ≥ 1 day The patient is able to give consent Exclusion Criteria: Participation in a prospective intervention study (except adjuvant therapy study) Patients with underlying neurological diseases that make it difficult to differentiate from delirium Missing contact 3 months after stay in the recovery room.

Ages Eligible for Study
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Minimum Age: 18 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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morbidity | Postoperative complications according to Clavien-Dindo classification | Up to three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of delirium | Duration of delirium is measured in days | Time until discharge from recovery room, an expected average of 5 days | 
| Incidence of delirium | Postoperative delirium rate, defined according to Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and/or as ≥ 2 cumulative points in the Nursing Delirium Screening Scale (Nu-DESC) and/or a positive Confusion Assessment Method (CAM) and/or Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) score and/or patient chart review that shows descriptions of delirium. | Time until discharge from recovery room, an expected average of 5 days | 
| Preventive measures against delirium 1 | Preventive measures of delirium are measured by medical treatments | Time until discharge from recovery room, an expected average of 5 days | 
| Preventive measures against delirium 2 | Preventive measures of delirium are measured by non-medical treatments | Time until discharge from recovery room, an expected average of 5 days | 
| Anticholinergic drugs | Measured by anticholinergic drug scale | Time until discharge from hospital, an expected average of 7 days | 
| Treatment of delirium | Treatment of delirium with medication | Time until discharge from hospital, an expected average of 7 days | 
| Measurement of acetylcholinesterase | Measurement of activities of the enzyme - acetylcholinesterase in blood | Time until discharge from recovery room, an expected average of 5 days | 
| Measurement of butyrylcholinesterase | Measurement of activities of the enzyme - butyrylcholinesterase in blood | Time until discharge from recovery room, an expected average of 5 days | 
| Chronic comorbid diseases | Chronic comorbid diseases (comorbidities) are measured by Charlson comorbidity index | Time until discharge from hospital, an expected average of 7 days | 
| Health related quality of life | EQ-5D | Up to three months | 
| Treatment of vegetative symptoms | Treatment of vegetative symptoms is measured by vegetative medical therapy | Time until discharge from recovery room, an expected average of 5 days | 
| Treatment of pain | Treatment of pain is measured by analgesia | Time until discharge from recovery room, an expected average of 5 days | 
| Treatment of postoperative vomiting | Treatment of postoperative vomiting is measured by anti-emetics | Time until discharge from recovery room, an expected average of 5 days | 
| Treatment of productive psychotic symptoms | Treatment of productive psychotic symptoms is measured by anti-psychotics | Time until discharge from recovery room, an expected average of 5 days | 
| Treatment of anxiety | Treatment of anxiety is measured by anxiolytics | Time until discharge from recovery room, an expected average of 5 days | 
| Treatment of sleep disorders | Treatment of sleep disorders are measured by sleeping drugs | Time until discharge from recovery room, an expected average of 5 days | 
| Number of participants with changes in laboratory values | Routine laboratory results were planned to be documented in the hospital including hemoglobin, lymphocytes, total neutrophils, platelet count and white blood cell (WBC) count from blood samples. | Time until discharge from hospital, an expected average of 7 days | 
| Apache II | APACHE II score is measured by the Acute Physiology and Chronic Health Evaluation System II. | Time until discharge from intensive care unit, an expected average of 6 days | 
| SOFA | SOFA is measured by Sequential Organ Failure Assessment. | Time until discharge from intensive care unit, an expected average of 6 days | 
| SAPS II | SAPS II is measured by Simplified Acute Physiology Score II. | Time until discharge from intensive care unit, an expected average of 6 days | 
| Intensive care unit stay | Intensive care unit stay is measured in days | Time until discharge from intensive care unit, an expected average of 6 days | 
| Hospital stay | Hospital stay is measured in days | Time until discharge from hospital, an expected average of 7 days |