Preoperative Comprehensive Geriatric Assessment (CGA) and Postoperative Delirium

University of Miami

Status: Enrolling

Conditions: CGA

Treatments: Other: control; Behavioral: CGA

Study type: Interventional

Funder types: Other

Identifiers

NCT07059585

20230790

Details and patient eligibility

About

The purpose of this research is to find out the best way to reduce delirium in frail, older patients undergoing planned surgery. Delirium is a state of confusion and difficulty concentrating that is temporary. Delirium may make the person anxious, angry, sleepy, not think clearly, or hallucinate. Being frail in medicine means that the body may not easily recover from a stressor, such as surgery. This study will determine if a detailed on-going evaluation by a Geriatrician, doctor who specializes in the care of older adults, after surgery is better at decreasing the risk of delirium than simply highlighting the patient's frailty in the electronic medical record.

Enrollment: 200 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Frailty as measured by the 5-modified frailty index (5-mFI) during the anesthesia preoperative assessment. The 5-mFI consists of 5 elements: 1-dependency for activities of daily living, 2-congestive heart failure within 30 days, 3-chronic obstructive pulmonary disease or pneumonia currently treated with antibiotics, 4-diabetes, and 5-hypertension. The diagnosis of frailty by the 5-mFI is based upon the presence of 2 or more of the elements.
2. Elective inpatient surgery with an expected LOS > 1 day;
3. Receiving general anesthesia
4. Adults who are unable to consent if they have a designated proxy able to consent

Exclusion criteria

1. Absence or withdrawal of informed consent,
2. Presence of current delirium
3. prisoners

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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200 participants in 2 patient groups

CGA group

Experimental group

Description:

Participants will receive the CGA intervention for up to 2 weeks

Treatment:

Behavioral: CGA

Control Group

Other group

Description:

Participants will receive standard of care treatment for up to 2 weeks

Treatment:

Other: control