Clinical trial NCT04840316: INcidence of PostOperative Delirium Incidence in Surgical Patients: an Observational Cohort Study in New Zealand
Official title: INcidence of PostOperative Delirium Incidence in Surgical Patients: an Observational Cohort Study in New Zealand
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Delirium Confusional State
Complication,Postoperative
Keywords: Anesthesia
Delirium
Incidence
Cognitive decline
Lead sponsor: Auckland City Hospital
Sponsor class: OTHER_GOV
First posted: 2021-04-12
Enrollment: 1
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Participant patients will have been assigned procedure codes for surgery and anaesthesia. Patients who had multiple procedures during an episode of care will have each procedure and relevant postoperative course analysed. Patients were excluded if the procedure was performed under local anaesthesia infiltration. Procedures performed under regional or neuraxial techniques will be included in the analysis.

Brief summary: As the population of older adults increases, so too with the number of older adult patients that present for anesthesia and surgery. The development of delirium following surgery has some significant potential effects on patient outcomes; however, POD is often under diagnosed. Some studies reported that more than 50% of patients with delirium were undiagnosed by clinical teams. POD is associated with cognitive decline, increased hospital length of stay, discharge to institutional care, mortality and higher healthcare costs. POD contributes significantly to healthcare inefficiency; a diagnosis of POD is estimated by the Australian Commission on Quality and Safety in Healthcare to cost an additional $27,791 AUD. The incidence of POD reported in clinical trials depends on the risk profile of the study population, the frequency and duration of delirium assessments as well as the surgical procedure. Reported incidence may also vary due to the presence of high-risk pathways involving multi-specialty management and intervention. POD may present as either hyperactive or hypoactive subtypes, the latter being more difficult to detect.

There are few reports on the incidence of POD in New Zealand national level datasets, with single centre studies primarily looking at in-hospital delirium and demonstrating an incidence of 11.2 to 29% on mixed and/or medical wards. A review of elderly patients with neck-of-femur fractures found the incidences of POD to be as high as 39%. The current data suggests a significant level of morbidity due to POD in New Zealand hospitals, however there is lack of national level data in the surgical population; which is crucial for establishing demographic and regional need for effective intervention.


Eligibility criteria: Eligible patients include those aged 18 years or over undergoing a surgical procedure in any of 71 public or private hospitals

Primary outcomes:
measure: Incidence of postoperative delirium
timeFrame: January 1st 2007 to December 31st 2016
Secondary outcomes:
Other outcomes:
Locations:
city: Auckland
country: New Zealand
facility: Auckland City Hopsital
Study officials:
References: