Atropine Weight and Risk of Postoperative Confusion in the Elderly
- Conditions
- Aging
- Interventions
- Other: Data collection
- Registration Number
- NCT03390751
- Lead Sponsor
- University Hospital, Toulouse
- Brief Summary
The identification of a high atropine load of treatment received during hospitalization as a predictor of postoperative confusion could have various benefits:
* Pharmacoepidemiological: identify factors associated with postoperative confusion
* Clinics: by favoring treatments with a low atropine load during anesthesia, the management of patients hospitalized in orthopedics. Similarly, stopping or re-evaluating treatments with a high atropine weight for scheduled surgery is an easy step to take.
* Socio-economic: by reducing the costs related to the occurrence of a confusional syndrome (over-treatment, prolonged hospital stay, loss of autonomy, institutionalization of patients...).
In total, the present study would improve the daily management of hospitalized patients and the practices of clinicians, by offering a decision-making aid.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 130
- Admitted to the orthopedic department for surgical management of a fracture of the upper end of the femur in emergency or for the installation of a hip or knee prosthesis
- Patient able to understand and respond to the protocol
- No opposition to the collection of data of the patient or his / her designee
- Pre-existing confusion to surgery, detected by the CAM scale
- Serious or moderate head trauma less than three months old
- Removing / installing prosthesis.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Aged patients Data collection Data collection of patients admitted to the orthopedic department of the University Hospital of Toulouse for surgical management of a fracture of the upper end of the femur in emergency or for the installation of a hip or knee prosthesis.
- Primary Outcome Measures
Name Time Method Association between atropine load of medications on the risk of postoperative confusion up to 7 days Occurrence of a postoperative confusion syndrome performed by Confusion Assessment Method (CAM) scale once a day. The CAM is a validated scale as a diagnostic scale for confusional syndrome at the patient's bedside with four parts : 1) confusion and fluctuation of symptoms, 2) inattention, 3) disorganization of thought, 4) disorder of consciousness.
Atropinic load of drugs up to 7 days The DURAN scale is the most recent and most comprehensive atropine load evaluation scale. This scale classifies the evaluated drugs into three categories: no anticholinergic power (atropine weight = 0), low anticholinergic activity (atropine weight = 1), high atropinic power (atropine weight = 3). All drugs received by the patient during 7 days will be classified with the Duran scale.
- Secondary Outcome Measures
Name Time Method Duration of hospitalization Up to discharge, an average of ten days Number of days of hospitalization (days) between surgery and discharge. Association between atropinic load of drugs and duration of hospitalization will be evaluated.
Autonomy Month 3 Description of autonomy of the patient at three months of surgery evaluated by the Activity Daily Living scale (ADL). The ADL scale evaluates activities of daily living: washing, dressing, going to the bathroom, ensuring transfers, continence and food. Each item is rated according to a level of dependence: independent (1 point), with assistance (0.5 points), unable to achieve (0 points). A total of 6 points indicates a total autonomy, and 0 a total dependency.
Cognitive dysfunction baseline Appearance postoperative cognitive dysfunction by the Mini Mental State (MMS). the total score of MMS wil be collected.
Trial Locations
- Locations (1)
Pierre-Paul-Riquet University Hospital
🇫🇷Toulouse, France