Acutely disturbed state of mind(Delirium)after operation(Surgery)

Completed

Conditions: All Patients planned for Elective Surgery

Registration Number: CTRI/2018/07/015125

Lead Sponsor: LHMC DELHI

Brief Summary: Delirium is a common problem in hospitalized patients, with aprevalence of 10-24% in medical population, 37â€“46% in surgical population, andupto 87% in ICU patients. In individuals over 65 years of age,hospitalized for medical conditions, approximately 10% exhibit delirium onadmission, and another 10-15% may develop delirium while in hospital (DSM IV1994).In Indian population, Rudraetal(2006)recorded 15% incidence ofdelirium in elderly patients after major elective surgeries.

Delirium is an acute and fluctuating disturbance ofconsciousness with reduced ability to focus, maintain, or shift attention,accompanied by change in cognition and perceptual disturbances, along with psychomotor, emotional and sleep-wakecycle disturbances.

Delirium is not a disease, but is a symptom of manypathological conditions, such as increasing age, dementia, infections,tumors, chronic diseases, metabolic disorders, fever, and intoxication. Post-operative delirium(POD) manifests in patients who haveundergone surgical procedures and anesthesia, usually peaking within threedays. Most recover within 4 weeks, but in 50% cases it may persistlonger. Incidence of POD varies with patientsage, pain scores, type of surgery, degree of operative stress, lowpre-operative executive scores and depression. POD is a serious complication, associated with increasedhospital and ICU length of stay, functional decline, high medical cost, 10 fold increased risk of dementia, post-discharge institutionalization anddeath. Mortality increases by 10â€“20% for every 48 hours ofdelirium, chiefly from association with other postoperative complications. Inliterature, most studies are in elderly patients and very few in the youngadult population. Hence, we decided to carry out this study for occurrence ofPOD in patients 20-60 years age, and identify risk factors that may help inearly diagnosis of Delirium and avoidance of POD.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 100

Inclusion Criteria

Patients 20-60 years of age, of either sex.
Elective surgeries under general anesthesia.
Elective surgeries under general anesthesia + Regional/Local anesthesia.

Exclusion Criteria

Age < 20 and > 60 years Emergency surgeries Thoracic/Cardiac/Obstetric/Orthopedic/Neurosurgery Sole Regional anesthesia/Local anesthesia Patients requiring postoperative ventilatory support Pre-existing neuropsychiatric disorder (seizures, Space occupying lesion(SOL), head injury) Patients on antipsychotic drugs and drug or alcohol abuse.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Proportion of postoperative delirium in patients undergoing elective surgeries under general anesthesia.	Confusion Assessment Method (CAM) applied preoperatively , and postoperatively at 2 hours, days 1, 2 and 3. VAS score (0-100 scale) used to assess pain at all times of observation.

Secondary Outcome Measures

Name	Time	Method
1. Relationship between postoperative delirium and preoperative cognitive status.	2. Relationship between postoperative delirium and intraoperative factors (hemodynamic changes, blood transfusions, duration of anesthesia) and postoperative pain scores.

Trial Locations

Locations (1): LHMC, SMT. S.K.HOSPITAL
🇮🇳
Central, DELHI, India
LHMC, SMT. S.K.HOSPITAL
🇮🇳Central, DELHI, India
DR JAVED KHAN
Principal investigator
9013834635
drjkhallim@gmail.com