Clinical trial NCT06498297: Analysis of the Impact of a Temporo-spatial Reorientation Tool on the Speed of Improvement of Confusional Syndrome
Official title: Analysis of the Impact of a Temporo-spatial Reorientation Tool on the Speed of Improvement of Confusional Syndrome, Assessed by the 4 "A" Test, in Patients Aged Over 75 Years Hospitalized in the Medical and Health Care Department. Geriatric Rehabilitation.
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Attention Disorder
Keywords: Attention Disorder
Confusion syndrome
Attentional disorders
Disorganization of cognitive functions
Lead sponsor: University Hospital, Strasbourg, France
Sponsor class: OTHER
First posted: 2024-07-12
Enrollment: 500
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patient aged 75 and over hospitalized at the HUS in the SMRG department during the period from January 1, 2021 to April 31, 2023 and havin passed at least a 4AT during hospitalization.

Brief summary: Confusion syndrome is defined by attentional disorders and disorganization of cognitive functions that are acute and reversible. There are patient-specific predisposing factors and precipitating factors. Elderly people, due to their comorbidities, are more at risk. Confusion syndrome affects approximately 23% of elderly patients in the medical department, 33% in the rehabilitation department and its occurrence is preventable in 30 to 40% of cases. The health expenditure generated by its occurrence was estimated at 182 billion dollars per year by combining the expenditure of 18 European countries in 2011. The occurrence of a delirium increases the duration of hospitalization, increases the risk of falls, loss of autonomy, can lead to an impairment of quality of life at 6 months and is linked to excess mortality.

The gold standard for making the diagnosis of delirium is the use of the DSM-5 criteria, but their use is time-consuming and requires that staff be trained in their use. The 4 "A" test (tool to help identify confusional syndrome) can be used to monitor confusional syndromes; it has the advantage of being able to be taken in less than 3 minutes.

Concerning the management of a confusional syndrome, a non-pharmacological multi-component approach is recommended as first line for its prevention but there is no treatment to date. A tool to help with temporo-spatial reorientation (La Rob'Gazette) has been set up in the Medical Care and Geriatric Rehabilitation (SMRG) departments of the HUS


Eligibility criteria: Inclusion Criteria:

* Patient aged 75 and over
* Hospitalized at the HUS in the SMRG department during the period from January 1, 2021 to April 31, 2023
* Passed at least a 4AT during hospitalization
* Absence of written opposition in the patient's medical file (and/or their legal representative if applicable) to the reuse of their data for scientific research purposes.

Exclusion Criteria:

- Presence of written opposition from the patient (and/or their legal representative if applicable) in their medical file.

Primary outcomes:
measure: Speed of improvement of the 4AT of the entire population
timeFrame: Up to 2 years
Secondary outcomes:
Other outcomes:
Locations:
city: Strasbourg
country: France
facility: Service de Soins de Soins Médicaux et de Réadaptation - CHU de Strasbourg - France
Study officials:
References: