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Redesigning the Surgical Pathway (PROMoTE)

Cognitive Impairment | Delirium | Cognitive Decline | Cognitive Dysfunction | Perioperative/Postoperative Complications

Cognitive complications, that is problems with thinking and memory, are incredibly common after surgery, occurring in 10-50% of all older surgical patients. These complications can take different forms, but one of the most common is postoperative delirium (POD), a short-term state of confusion. In addition to being stressful for patients and their families, POD is linked to longer hospital stays, increased costs, higher mortality rates and other problems after surgery. Despite this, POD is often not recognized by doctors and there are currently no effective medications to treat POD. However, simple strategies such as helping patients to sleep properly and remain hydrated, have been shown to help.

This study is testing if a delirium-reduction program will reduce postoperative delirium (POD) in older surgical patients. The investigators will first test memory and thought processes before surgery to find people who are most likely to develop POD. Once these people have been identified, they will be enrolled in a program which includes recommendations for their care team (e.g. surgeon, anesthesiologist, nurses) as well as educational materials for them and their family related to things that can be done to prevent delirium. By identifying at-risk patients and making sure that their doctors and caregivers are aware of how to prevent delirium, the investigators expect that this study will make surgery safer for older surgical patients.

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Participation Requirements

  • Sex:

    ALL
  • Eligible Ages:

    60 and up

Participation Criteria

Inclusion Criteria:

* ≥ 60 years old
* Undergoing major elective surgery (e.g., intra-abdominal, retroperitoneal, major orthopedic) with an expected postoperative stay of at least 1 night
* Evidence of cognitive impairment on baseline screening tests (i.e. any score \< 90 on CBB or \>10 on S-OMCT)

Exclusion Criteria:

* Patients undergoing cardiac surgery
* Patients undergoing intracranial neurosurgery
* Patients with known substance use disorder (verbally declared by patients)
* Unlikely to comply with study assessment (e.g., no fixed address, without access to internet/computer/phone).

Study Location

Sunnybrook Health Sciences Centre
Sunnybrook Health Sciences Centre
Toronto, Ontario
Canada

Contact Study Team

Primary Contact

Stephen Choi, MD

[email protected]
416 4804864
Study Sponsored By
Sunnybrook Health Sciences Centre
Participants Required
More Information
Study ID: NCT05114876