Delirium and Neuropsychological Recovery Among Emergency General Surgery Survivors

Launched by UNIVERSITY OF WISCONSIN, MADISON · May 12, 2022

Keywords

ClinConnect Summary

This clinical trial is studying a new approach called the Urgent and Emergency Surgery (UES) Delirium Recovery Model, which aims to help older adults recover better after experiencing delirium following emergency surgeries. Delirium is a sudden change in mental status that can cause confusion and make it hard for people to think clearly. The researchers believe that using this recovery model will improve cognitive (thinking), physical, and psychological (emotional) recovery for these patients. Participants in the study will be involved for about 18 months.

To be eligible for this study, individuals must be 65 years or older, have had emergency surgery for conditions like abdominal or orthopedic issues, and have experienced at least one episode of delirium before leaving the hospital. They also need access to a phone or internet device and must be able to give consent or have someone to help with that. It's important to note that people with certain medical histories, like dementia or severe neurological issues, will not be included in the study. If you or a family member meet these requirements, participating in this trial could offer valuable support during recovery after surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult age 65 years and older
• • Admitted to one of the participating hospitals
• • Undergone an abdominal orthopedic, skin, or vascular surgery in an emergency or unplanned fashion
• • English-speaking
• • Able to provide consent or have a legally authorized representative to provide consent
• • Access to a telephone or an internet connected computer or smart device
• • Discharged to home or sub-acute rehabilitation
• • At least one episode of delirium or subsyndromal delirium, i.e. screen positive on at least one out of the four items on the Confusion Assessment Method-ICU (CAM-ICU) in the period prior to discharge from acute care.
• Exclusion Criteria:
• • A self-reported diagnosis of cancer with short life expectancy
• • A history of dementing illnesses and other neurodegenerative disease such as Alzheimer's disease (AD), Parkinson disease, or vascular dementia, or current prescription of anti-dementia medication, or ruled out by Functional Activities Questionnaire (FAQ) score defining dementia; a history of significant traumatic brain injury
• • Acute or subacute neurologic deficit expected to prevent independent living after hospital discharge, e.g., a history of a significant traumatic brain injury
• • Have any spinal cord injury with persistent neurologic deficit at the time of study enrollment
• • Incarcerated or homeless at the time of study enrollment
• • Acquired neurologic injury (stroke, traumatic brain injury, cerebral edema/swelling, anoxic brain injury, or any other acute/subacute severe neurologic deficit) as the admitting diagnosis or a new event during the course of hospitalization (confirmed by EMR)
• • A history of bipolar disorder or schizophrenia (confirmed by EMR)