Comparison of DRS-R-98 and 3D-CAM in the Assessment of Postoperative Delirium in Elderly Patients

NCT05992818 | Completed

• 1 other identifier: 2022/2132
• Study Type: observational
• Target: 270
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative delirium (POD) is a transient and usually fully reversible altered state of consciousness that develops acutely or subacutely after surgery, characterized by widespread, daily fluctuations in brain metabolism and function. It can be seen as hyperactive (mania), hypoactive (depressive) and mixed type. It has been shown to be associated with increased morbidity, mortality, health expenditures and prolonged hospitalization in the postoperative period. In studies, the frequency of POD was found to be 17-51% in orthopedic surgery, 11-46% in cardiac surgery and 13-50% in non-cardiac surgery. There are many studies in the literature on advanced age, comorbidities (e. g; diabetes mellitus, stroke, coronary artery disease, arrhythmias), dementia, use of glasses-hearing aids, medications (anticholinergic, opioid, benzodiazepine etc. ), duration of anesthesia, type of surgery, electrolyte disturbances, perioperative bleeding, hypotension, pain and intensive care unite stay as risk factors associated with delirium. This condition, which has a multifactorial etiology, is often unrecognized, unpreventable, untreatable and leads to increased morbidity and mortality. Therefore, it is important to recognize delirium that develops in the postoperative period and to perform the necessary interventions. There are many tests used in the diagnosis of POD. Delirium tests; it evaluates the patient under many sub-headings such as orientation, memory, attention, visual and spatial ability. The gold standard method is DSM-V (North American Diagnostic and Statistical Manual-V of Mental Disorders-V) to assess delirium status. There are also some other tests like DRS-R-98 (The Delirium Rating Scale--Revised-98) and 3D-CAM (3-minute diagnostic assessment for CAM-Confusion Assessment Method-defined delirium). In addition to patient assessment, these tests are useful for the clinician in the diagnosis of delirium. The aim of the study is to compare the DRS-R-98 and 3D-CAM tests used in the assessment of POD, and to evaluate their feasibility and the power detecting delirium.

Conditions

Postoperative Delirium

Keywords

Elderly patients; DRS-R-98(The Delirium Rating Scale--Revised-98); 3D-CAM; delirium

Outcome Measures

Primary Outcomes (1)

• Comparing the tests (3D-CAM and DRS-R-98) in the assessment of postoperative delirium.

  the specificity, sensitivity and consistency of 3D-CAM and DRS-R-98 tests used in the evaluation of postoperative delirium. Both tests include sections that assess the patient's responses to the questions asked and also the practitioner's observations

  2 days

Secondary Outcomes (3)

• incidence of postoperative delirium

  2 days

• length of hospital stay

  2-21 days

• postoperative pain assessment with Numeric Rating Scale (NRS)

  2 days

Interventions

comparing DRS-R-98 (The Delirium Rating Scale--Revised-98) and 3D-CAM (3-minute diagnostic assessment for CAM-Confusion Assessment Method-defined delirium) tests to assess postoperative delirium DIAGNOSTIC_TEST

determine the test that is more effective and practical in the assessment of POD

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

≥ 65 years male and female orthopedic, urological, thoracic, vascular (off-pump) and general surgery operations

You may qualify if:

• orthopedic, urological, thoracic, vascular and general surgery operations
• Emergency and elective surgery
• Patients with voluntary consent
• Patients aged ≥ 65 years
• Surgeries longer than 60 minutes

You may not qualify if:

• \< 65 years old patients
• Operations that take less than 60 minutes
• Patients who do not speak Turkish
• Patients who cannot legally give consent (eg dementia)
• Patients without consent
• Outpatient surgeries
• Reoperated or reintubated patients

Sponsors & Collaborators

• Istanbul University: lead

Study Sites (1)

Istanbul Faculty of Medicine

Istanbul, Turkey (Türkiye)

Location

Related Publications (5)

• Oh ST, Park JY. Postoperative delirium. Korean J Anesthesiol. 2019 Feb;72(1):4-12. doi: 10.4097/kja.d.18.00073.1. Epub 2018 Aug 24.

  PMID: 30139213 RESULT

• Janssen TL, Alberts AR, Hooft L, Mattace-Raso F, Mosk CA, van der Laan L. Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis. Clin Interv Aging. 2019 Jun 19;14:1095-1117. doi: 10.2147/CIA.S201323. eCollection 2019.

  PMID: 31354253 RESULT

• American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5Ⓡ). 5th ed. Arlington, American Psychiatric Association Publishing. 2013, pp 596-601.

  RESULT

• Palihnich K, Inouye SK, Marcantonio ER. The 3D CAM Training Manual for Research. 2014; Boston: Hospital Elder Life Program

  RESULT

• Cinar MA,Ozmenler KN ,Ozsahin A ,Trzepacz Paula T. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2014; 3(27): 186-193 DOI: 10.5350/DAJPN2014270301

  RESULT

MeSH Terms

Conditions

Emergence Delirium; Delirium

Condition Hierarchy (Ancestors)

Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neurocognitive Disorders; Mental Disorders

Study Officials

• Zerrin SUNGUR, Prof Dr

  Istanbul University Istanbul Faculty of Medicine Department of Anesthesiology and Reanimation

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 5, 2023
• First Posted: August 15, 2023
• Study Start: August 16, 2023
• Primary Completion: December 20, 2023
• Study Completion: December 25, 2023
• Last Updated: March 12, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)