[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"postoperative-delirium-pod\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:postoperative-delirium-pod":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,19,0,[8,51,82,104,131,152,181,208,244,269,299,327,355,388,410,442,466,494,517],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":32,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":39,"lastUpdatePostDateStruct":40,"startDateStruct":43,"completionDateStruct":45,"leadSponsor":47,"locationsCount":50},"100519351","prediction-and-prevention-of-postoperative-mortality-and-morbidity-100519351",false,"NCT06042413","Prediction and Prevention of Postoperative Mortality and Morbidity","Real-world and Innovative Multimodal Prediction and Prevention of Postoperative Mortality and Multi-morbidities","Part I Inclusion Criteria:\n\n* 65 years of age and older\n* Identified as higher risk (≥2.5%) for 30-day mortality and MACCE based on the UPMC's Perioperative Model (EHR risk prediction algorithm)\n* Scheduled for major cardiac surgeries including coronary artery bypass and valvular repair and\u002For vascular surgeries including carotid endarterectomy, aortic aneurysm repair, and major vascular surgeries\n* RAI score ≥ 30\n* Informed consent\n* English speaking patients\n\nPart II Inclusion Criteria:\n\n* Enrolled in Aim 1 \u002F Part I Preoperative Intervention Trial\n* Scheduled for high-risk, cardiac or vascular surgery requiring intraoperative neurophysiological monitoring (IONM)\n* Moderate and high risk for mortality based on Society of Thoracic Surgery score (score \\>4)\n\nPart I Exclusion Criteria:\n\n* Children (\\\u003C18 years)\n* Patients unable to provide consent\n* Participants undergoing same day procedures or operations (discharged same day)\n* Patients with severe preoperative medical diseases such as blindness or significant visual impairment, unresolved motor weakness, or any other perioperative events or complications that would have a bearing on the patient's ability to perform study tasks, neuropsychological tests, and proposed interventions\n\nPart II Exclusion Criteria:\n\n* Pregnant women\n* Patients do not provide consent.\n* Patients are unable to participate in cognitive and other behavioral assessment due to physical limitations\n* Patients refuse any blood transfusions during surgery","ALL","65 Years",{"count":19,"type":20},1200,"ESTIMATED","INTERVENTIONAL",[23],"NA","This study will contribute to creating a prospective and automated preoperative risk assessment algorithm for predicting 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE), and postoperative neurocognitive outcomes following elective cardiac and vascular surgery in older adults. It will evaluate associations between perioperative factors and longer-term neurocognitive outcomes, including postoperative neurocognitive disorder and dementia. In addition, this study will assess scalable, multimodal preoperative and intraoperative interventions to improve perioperative outcomes.\n\nThis study will explore two main hypotheses:\n\n1. Preoperative personalized prehabilitation with proactive cognitive and behavioral interventions will improve postoperative cognitive outcomes, morbidity, and mortality in high-risk elderly surgical patients.\n2. Proactive bundled intraoperative interventions are superior to reactive standard of care in reducing postoperative cognitive outcomes, MACCE, and mortality.\n\nExpected Outcome: Improved EHR algorithm will have higher predictive accuracy for MACCE and mortality while predicting postoperative cognitive outcomes.",[26,27,28,29,30,31],"Dementia","Postoperative Delirium (POD)","Postoperative Neurocognitive Disorder","Major Adverse Cardiac and Cerebrovascular Events","Perioperative Complications","Postoperative Cognitive Decline",[33,34,35,36,37],"MACCE","Cognitive decline","Perioperative brain health","Neurocognitive disorder","Postoperative delirium","NOT_YET_RECRUITING","2026-06-02",{"date":41,"type":42},"2026-06-04","ACTUAL",{"date":44,"type":20},"2026-06",{"date":46,"type":20},"2027-06",{"name":48,"class":49},"University of Pittsburgh","OTHER",5,{"id":52,"slug":53,"hasResults":11,"nctId":54,"briefTitle":55,"officialTitle":56,"acronym":4,"eligibilityCriteria":57,"healthyVolunteers":11,"sex":16,"minAge":58,"maxAge":4,"enrollmentInfo":59,"targetDuration":4,"studyType":21,"phases":61,"briefSummary":63,"conditions":64,"keywords":65,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":73,"lastUpdatePostDateStruct":74,"startDateStruct":75,"completionDateStruct":77,"leadSponsor":79,"locationsCount":81},"100637300","phase-3-ketofol-versus-ketodex-for-pod-prophylaxis-in-elderly-cancer-surgery-100637300","NCT07627906","Ketofol Versus Ketodex for POD Prophylaxis in Elderly Cancer Surgery","Neuroprotective Effects of Ketofol Versus Ketodex on Postoperative Delirium in Elderly Patients Undergoing Pelvi-abdominal Cancer Surgeries. A Randomized Double-blinded Comparative Study.","Inclusion Criteria:\n\n* Patients aged ≥ 60 years.\n* ASA physical status II and III.\n* Scheduled for open pelvi-abdominal cancer surgeries.\n* Able to communicate verbally.\n* BMI \\\u003C 35 kg\u002Fm2.\n\nExclusion Criteria:\n\n* Patient's refusal to participate.\n* Laparoscopic procedures.\n* Severe hepatic (Liver enzymes are more than threefold) and renal impairment (Creatinine clearance is less than 30 ml\u002Fmin).\n* Severe cardiac disease (EF ≤ 40%, recent MI in the previous 3 months, NYHA ≥ III) and pulmonary disease (FEV1\u002FFVC ratio \\\u003C 50% predicted and\u002For FEV1 \\\u003C 50% predicted)\n* Patients require postoperative ICU admission with mechanical ventilation and or inotropic support.","60 Years",{"count":60,"type":20},180,[62],"PHASE3","Postoperative delirium (POD) is a common and serious neurocognitive complication after surgery, particularly in elderly patients undergoing major cancer surgeries. It is associated with prolonged hospital stay, impaired quality of life, increased postoperative cognitive dysfunction, and higher mortality. The pathophysiology of POD is multifactorial and involves neuroinflammation, oxidative stress, impaired cerebral perfusion, and neurotransmitter imbalance.\n\nSeveral anesthetic agents have been investigated for their potential neuroprotective effects against POD. Ketamine, through NMDA receptor antagonism, may reduce neuroinflammation and provide hemodynamic stability and opioid-sparing analgesia, although concerns remain regarding hallucinations and psychomimetic effects. Propofol, acting through GABA receptor activation, may protect against oxidative neuronal injury but may also induce hypotension in elderly patients. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promising sedative, analgesic, and anti-inflammatory properties with potential protective effects against POD, although bradycardia and uncertainty regarding optimal dosing remain concerns.\n\nCombinations such as ketofol (ketamine-propofol) and ketodex (ketamine-dexmedetomidine) may provide synergistic benefits by improving hemodynamic stability, analgesia, and sedation while minimizing adverse effects. Previous studies have demonstrated favorable perioperative outcomes with both combinations; however, direct comparisons regarding their role in preventing postoperative delirium in elderly patients undergoing pelvi-abdominal cancer surgeries remain limited. Therefore, this study aims to compare the efficacy and safety of ketofol versus ketodex as prophylactic strategies against POD in this high-risk population.",[27],[66,67,68,69,70,71],"ketofol","ketodex","ketamine","dexmedetomidine","postoperative delirium","postoperative cognitive dysfunction","RECRUITING","2026-05-30",{"date":41,"type":42},{"date":76,"type":20},"2026-07",{"date":78,"type":20},"2027-02",{"name":80,"class":49},"Cairo University",1,{"id":83,"slug":84,"hasResults":11,"nctId":85,"briefTitle":86,"officialTitle":87,"acronym":4,"eligibilityCriteria":88,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":89,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":92,"conditions":93,"keywords":4,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":95,"lastUpdatePostDateStruct":96,"startDateStruct":98,"completionDateStruct":100,"leadSponsor":102,"locationsCount":81},"100631569","sex-dependent-risk-of-postoperative-delirium-and-mediating-effects-of-family-visits-100631569","NCT07502391","Sex-Dependent Risk of Postoperative Delirium and Mediating Effects of Family Visits","Sex-Dependent Risk of Postoperative Delirium and Mediating Effects of Family Visits: A Prospective Observational Study","Inclusion Criteria:\n\n* Informed consent as documented by signature;\n* ≥65 years of age;\n* Scheduled non-cardiac surgery with expected surgery duration ≥ 2 hours;\n* Under either general or spinal anesthesia.\n\nExclusion Criteria:\n\n* Known drug or alcohol abuse;\n* Requirement for postoperative ventilation;\n* Current participation in another study with an investigational drug;\n* Inability to complete the study assessments.",{"count":90,"type":20},471,"OBSERVATIONAL","Postoperative delirium is a common and serious complication after surgery, affecting 10-40% of older patients undergoing non-cardiac procedures. It is characterized by sudden changes in attention, awareness, and thinking that fluctuate throughout the day. Delirium is associated with longer hospital stays, higher mortality, worse long-term brain function, and substantially increased healthcare costs. While several risk factors are known, it remains unclear whether a patient's sex independently influences the risk of developing postoperative delirium, as existing studies have produced conflicting results and were often not designed to specifically examine sex differences.Family visitation is a promising non-drug approach to preventing delirium. Studies in intensive care patients have shown that those who receive family visits have a significantly lower risk of developing delirium. However, it is unknown whether men and women receive different amounts of family visits after surgery, and whether any such difference could help explain sex-based disparities in delirium risk. Given that traditional gender roles in caregiving persist, women - who often serve as primary caregivers in their families - may receive fewer visits when they themselves become patients.This prospective observational study led by the University of Zurich will enroll 471 patients aged 65 years or older undergoing non-cardiac surgery lasting at least 2 hours under general or spinal anesthesia. The primary aim is to determine whether female patients have a higher risk of developing postoperative delirium within three days after surgery compared to male patients. Delirium will be assessed twice daily using the 4 A's Test (4AT), a validated and standardized screening tool. The secondary aim is to evaluate whether female patients receive fewer family visits than male patients and whether any difference in visitation mediates the sex-dependent delirium risk. Family visits will be recorded using an anonymous sign-in sheet placed in the patient's room. The study does not involve any experimental interventions; all patients receive standard clinical care. Participation is voluntary, and withdrawal is possible at any time without affecting medical treatment.",[27,94],"Sex Differences","2026-05-27",{"date":97,"type":42},"2026-06-01",{"date":99,"type":42},"2026-05-05",{"date":101,"type":20},"2028-12-31",{"name":103,"class":49},"Julian Rössler",{"id":105,"slug":106,"hasResults":11,"nctId":107,"briefTitle":108,"officialTitle":109,"acronym":4,"eligibilityCriteria":110,"healthyVolunteers":111,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":112,"targetDuration":4,"studyType":21,"phases":114,"briefSummary":116,"conditions":117,"keywords":118,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":123,"lastUpdatePostDateStruct":124,"startDateStruct":126,"completionDateStruct":127,"leadSponsor":129,"locationsCount":4},"100637307","phase-4-dexmedetomidine-nasal-spray-on-postoperative-delirium-in-elderly-thoracoscopic-lung-resection-patients-100637307","NCT07579806","Dexmedetomidine Nasal Spray on Postoperative Delirium in Elderly Thoracoscopic Lung Resection Patients","The Effect of Dexmedetomidine Nasal Spray on Postoperative Delirium in Elderly Patients Undergoing Thoracoscopic Lung Resection","Inclusion Criteria:\n\n* American Society of Anesthesiologists (ASA) physical status II-III.\n* Age ≥ 65 years, with no gender restriction.\n* Patients scheduled for elective thoracoscopic lung resection under general anesthesia, with an expected operative duration of 1-4 hours.\n* Body mass index (BMI) between 18 kg\u002Fm² and 30 kg\u002Fm².\n\nExclusion Criteria:\n\n* Known hypersensitivity to dexmedetomidine hydrochloride or any of the excipients in the investigational product.\n* Pre-existing nasal conditions, nasal surgery, or nasal allergies that may significantly impair nasal drug absorption (e.g., chronic nasal congestion, rhinorrhea, epistaxis, nasal anatomical abnormalities, or mucosal pathology affecting absorption).\n* History of cranial trauma.\n* Pre-existing diagnosis or clinical suspicion of neurocognitive impairment, defined as a Mini-Mental State Examination (MMSE) score \\\u003C 24.\n* History of schizophrenia, epilepsy, Parkinson's disease, or myasthenia gravis.\n* History of alcohol or substance abuse\u002Fdependence.\n* Left ventricular ejection fraction \\\u003C 30%; sick sinus syndrome; severe sinus bradycardia (\\\u003C 50 bpm); or second- or higher-degree atrioventricular block without permanent pacemaker implantation.\n* History of myocardial infarction, unstable angina, severe cardiac arrhythmia, or decompensated cardiac insufficiency.\n* Asthma, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease (COPD) considered inappropriate for study participation by the investigator.\n* Severe hepatic impairment (Child-Pugh Class C).\n* Severe renal dysfunction requiring preoperative dialysis.\n* Inability to provide valid informed consent due to cultural background, language barrier, or cognitive impairment.\n* Refusal to sign the informed consent form.\n* Other conditions deemed inappropriate for study participation by the investigator.",true,{"count":113,"type":20},264,[115],"PHASE4","This clinical trial is designed to observe the effect of dexmedetomidine nasal spray on the incidence of postoperative delirium in elderly patients undergoing thoracoscopic lung resection. Eligible elderly patients scheduled for thoracoscopic lung resection will be randomly divided into two groups: the dexmedetomidine group will receive dexmedetomidine hydrochloride nasal spray, while the placebo group will be administered an equivalent volume of placebo nasal spray. The primary outcome is the incidence of postoperative delirium within 3 days after surgery. Secondary outcomes include the severity and duration of delirium, as well as postoperative pain, subjective sleep quality, and the incidence of adverse events, which will be compared between the two groups to evaluate the safety and efficacy of dexmedetomidine nasal spray.",[27],[119,120,121,122,27],"Dexmedetomidine Nasal Spray","Elderly (people aged 65 or more)","Video-assisted thoracoscopic surgery (VATS)","Lung resection procedures","2026-05-06",{"date":125,"type":42},"2026-05-12",{"date":97,"type":20},{"date":128,"type":20},"2026-12-31",{"name":130,"class":49},"Sichuan Provincial People's Hospital",{"id":132,"slug":133,"hasResults":11,"nctId":134,"briefTitle":135,"officialTitle":135,"acronym":4,"eligibilityCriteria":136,"healthyVolunteers":11,"sex":16,"minAge":58,"maxAge":4,"enrollmentInfo":137,"targetDuration":4,"studyType":21,"phases":139,"briefSummary":140,"conditions":141,"keywords":4,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":143,"lastUpdatePostDateStruct":144,"startDateStruct":146,"completionDateStruct":148,"leadSponsor":150,"locationsCount":81},"100576703","impact-of-sevoflurane-versus-propofol-on-postoperative-delirium-in-elderly-diabetic-patients-undergoing-non-cardiac-surgery-a-multicenter-randomized-controlled-trial-100576703","NCT06788743","Impact of Sevoflurane Versus Propofol on Postoperative Delirium in Elderly Diabetic Patients Undergoing Non-Cardiac Surgery: a Multicenter, Randomized Controlled Trial","Inclusion Criteria:\n\n* Age ≥60 years\n* Elective surgery (with an expected duration of 2 hours or more)\n* ASA grade Ⅰ-Ⅲ\n* Voluntary participation and informed consent obtained\n* Diabetes mellitus\n\nExclusion Criteria:\n\n* Pre-operative BMI≥35 kg\u002Fm² (Class II obesity or above)\n* Severe hepatic dysfunction (Child-Pugh class C) or pre-operative dialysis-dependent renal dysfunction\n* Known neurological or psychiatric diseases (Parkinson's disease, depression, schizophrenia), or cognitive impairment (dementia)\n* Severe visual or auditory impairments, language barriers, or patients who cannot cooperate\n* Long-term use of sedatives, antipsychotic drugs, or long-term alcohol abuse\n* Neurosurgical patients\n* Patients with a known allergy to the drugs used in this study or those suspected of having propofol infusion syndrome",{"count":138,"type":20},450,[23],"The present study is a multicenter， randomized controlled clinical trial, which plans to enroll 450 diabetic patients aged more than 60 years. The participants will be randomly assigned in a 1:1 ratio and will receive either propofol or sevoflurane for intraoperative anesthesia maintenance to evaluate the impact of these two anesthetic drugs on postoperative delirium. The aim of our study is to explore whether the use of propofol for anesthesia maintenance in elderly diabetic patients undergoing elective non-cardiac major surgery can reduce the incidence of postoperative delirium. This study will provide new perspectives for improving perioperative management in elderly diabetic patients and optimizing anesthesia management strategies to reduce the risk of postoperative delirium.",[27,142],"Diabetes","2026-04-13",{"date":145,"type":42},"2026-04-16",{"date":147,"type":42},"2025-06-01",{"date":149,"type":20},"2026-05-31",{"name":151,"class":49},"Xijing Hospital",{"id":153,"slug":154,"hasResults":11,"nctId":155,"briefTitle":156,"officialTitle":157,"acronym":158,"eligibilityCriteria":159,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":160,"enrollmentInfo":161,"targetDuration":4,"studyType":21,"phases":163,"briefSummary":165,"conditions":166,"keywords":170,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":172,"lastUpdatePostDateStruct":173,"startDateStruct":175,"completionDateStruct":177,"leadSponsor":179,"locationsCount":4},"100634330","phase-2-minimizing-delirium-with-nasal-dexmedetomidine-induced-sleep-middies-100634330","NCT07538284","MInimizing Delirium With Nasal Dexmedetomidine-InducEd Sleep (MIDDIES)","Minimizing Delirium With Nasal Dexmedetomidine-Induced Sleep in Older Patients Undergoing Major Abdominal Surgery: : a Randomized, Double-blind, Placebo-controlled Trial","MIDDIES","Inclusion Criteria:\n\n* Aged 65-90 years\n* Scheduled for a major abdominal surgery with estimated surgery time ≥ 2 hours\n\nExclusion Criteria:\n\n* Blind, deafness or the inability to speak mandarin\n* Allergy to dexmedetomidine.\n* Renal and liver failure requiring dialysis or Child-Pugh score \\> 5\n* Follow-up difficulties (i.e. active substance abuse, psychotic disorder, homelessness)\n* Previous major abdominal or cardiac surgery within 1 year of surgical procedure\n* Chronic therapy with benzodiazepines and\u002For antipsychotics. Severe deficit due to structural or anoxic brain damage\n* Body weight \\\u003C 35 kg","90 Years",{"count":162,"type":20},400,[164,62],"PHASE2","This study aims to determine whether, compared with placebo, the nighttime self-administration of a nasal dexmedetomidine is effective at inducing sleep and preventing postoperative delirium in high-risk patients.",[167,27,168,169],"Major Abdominal Surgery","Sleep Disturbances","Intranasal Dexmedetomidine",[69,171],"intranasal administration","2026-04-12",{"date":174,"type":42},"2026-04-20",{"date":176,"type":20},"2026-05-01",{"date":178,"type":20},"2027-06-30",{"name":180,"class":49},"Sixth Affiliated Hospital, Sun Yat-sen University",{"id":182,"slug":183,"hasResults":11,"nctId":184,"briefTitle":185,"officialTitle":186,"acronym":4,"eligibilityCriteria":187,"healthyVolunteers":111,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":188,"targetDuration":189,"studyType":91,"phases":4,"briefSummary":190,"conditions":191,"keywords":196,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":199,"lastUpdatePostDateStruct":200,"startDateStruct":202,"completionDateStruct":204,"leadSponsor":206,"locationsCount":81},"100617141","elderly-patients-undergoing-surgery-during-perioperative-period-100617141","NCT07314762","Elderly Patients Undergoing Surgery During Perioperative Period","Elderly Patients Undergoing Surgery During Perioperative Period: a Prospective Cohort Study","Inclusion Criteria:\n\n1\\) Surgical patients aged 65 or above or non-surgical subjects aged 65 or above. 2) Agree to participate in this study and sign the informed consent form.\n\nExclusion Criteria:\n\n1）Refused to participate in the study.",{"count":19,"type":20},"1 Year","The elderly patients have poorer overall conditions and have lower tolerance to trauma, anesthesia, and surgery. Therefore, the incidence of postoperative complications is relatively higher. In non-cardiac surgeries, approximately 20% of elderly patients experience postoperative complications, and the incidence of postoperative delirium (POD) is 23.8%. This may lead to prolonged hospital stays, increased hospital costs, and affect prognosis and even mortality. The investigators plan to conduct a prospective cohort study by systematically collecting biological samples and clinical information of elderly patients during the perioperative period to explore the possible risk factors and pathogenesis of postoperative delirium and postoperative complications in elderly surgical patients, and to construct a risk prediction model for postoperative complications.",[192,193,27,194,195],"Postoperative Complications","Elderly","Risk Prediction Model","Pathogenesis",[70,197,198],"elderly","Cohort study","2026-03-26",{"date":201,"type":42},"2026-04-01",{"date":203,"type":42},"2023-12-30",{"date":205,"type":20},"2030-12-30",{"name":207,"class":49},"Second Affiliated Hospital of Wenzhou Medical University",{"id":209,"slug":210,"hasResults":11,"nctId":211,"briefTitle":212,"officialTitle":213,"acronym":4,"eligibilityCriteria":214,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":58,"enrollmentInfo":216,"targetDuration":4,"studyType":21,"phases":218,"briefSummary":219,"conditions":220,"keywords":225,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":234,"lastUpdatePostDateStruct":235,"startDateStruct":237,"completionDateStruct":239,"leadSponsor":241,"locationsCount":243},"100620427","comparison-of-target-controlled-and-manual-total-intravenous-anesthesia-in-supratentorial-surgery-100620427","NCT07357480","Comparison of Target-Controlled and Manual Total Intravenous Anesthesia in Supratentorial Surgery","Comparison of Target-Controlled Infusion Using the Eleveld Model and Manual Total Intravenous Anesthesia on Intraoperative Anesthetic Consumption and Postoperative Pain and Delirium in Supratentorial Surgery","Inclusion Criteria:\n\n* Adult patients aged 18 to 60 years\n* Scheduled for elective supratentorial surgery under general anesthesia\n* American Society of Anesthesiologists (ASA) physical status I or II\n* Planned total intravenous anesthesia with propofol and remifentanil\n* Ability to provide written informed consent\n\nExclusion Criteria:\n\n* Refusal or inability to provide written informed consent\n* American Society of Anesthesiologists (ASA) physical status III or higher\n* Pregnancy\n* Emergency surgery\n* Presence of brain herniation\n* Anticipated or documented difficult airway\n* Inability to communicate effectively (e.g., non-Turkish speaking or hearing impairment)\n* Preoperative risk factors for delirium, including substance abuse, use of neuropsychiatric medications, preoperative hemoglobin level \\\u003C 8 g\u002FdL, malnutrition, or electrolyte or thyroid hormone abnormalities\n* Intraoperative deviation from the study protocol, including changes in surgical or anesthetic technique or occurrence of major intraoperative complications\n* Contraindications to propofol or remifentanil","18 Years",{"count":217,"type":20},70,[23],"This study aims to investigate the effect of target-controlled infusion using the Eleveld pharmacokinetic model compared with manually controlled total intravenous anesthesia on the incidence of postoperative delirium in patients undergoing supratentorial surgery. Propofol and remifentanil are administered using either target-controlled or manual infusion techniques according to the study protocol. Secondary objectives include comparisons of intraoperative anesthetic consumption, hemodynamic responses, recovery profiles, postoperative pain, and postoperative nausea and vomiting between the two anesthesia strategies. The study seeks to evaluate whether target-controlled infusion provides improved anesthetic management and postoperative outcomes compared with manual total intravenous anesthesia.",[27,221,222,223,224],"Postoperative Pain","PONV","Burst Suppression","Recovery Period, Anesthesia",[226,227,228,229,230,231,232,233],"Target Controlled Infusion","Total Intravenous Anesthesia","Eleveld Model","Postoperative Delirium","Supratentorial Surgery","Bispectral Index","Propofol","Remifentanil","2026-03-24",{"date":236,"type":42},"2026-03-25",{"date":238,"type":42},"2026-01-14",{"date":240,"type":20},"2026-05",{"name":242,"class":49},"Istanbul University - Cerrahpasa",2,{"id":245,"slug":246,"hasResults":11,"nctId":247,"briefTitle":248,"officialTitle":248,"acronym":4,"eligibilityCriteria":249,"healthyVolunteers":11,"sex":16,"minAge":58,"maxAge":4,"enrollmentInfo":250,"targetDuration":4,"studyType":21,"phases":252,"briefSummary":253,"conditions":254,"keywords":257,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":260,"lastUpdatePostDateStruct":261,"startDateStruct":263,"completionDateStruct":265,"leadSponsor":267,"locationsCount":81},"100629851","a-phase-ii-clinical-two-stage-study-of-transcranial-magnetic-stimulation-in-preventing-postoperative-delirium-in-elderly-patients-after-urological-surgery-100629851","NCT07480044","A Phase II Clinical Two-Stage Study of Transcranial Magnetic Stimulation in Preventing Postoperative Delirium in Elderly Patients After Urological Surgery","Inclusion Criteria:(1) Age ≥ 60 years old; (2) Patients scheduled for elective urological surgery under general anesthesia with tracheal intubation; (3) ASA classification I - III; (4) Estimated operation duration ≥ 2 hours; (5) Informed consent from the patient or their guardian; (6) Proficient in communicating in Chinese. -\n\nExclusion Criteria:(1) Patients with permanent lack of autonomy (2) Not applicable for delirium assessment: including language disorders, deafness, blindness or aphasia, coma (3) With treatment abandonment or brain death (4) Known pregnancy or lactation (5) Unable to obtain consent according to national regulations (6) Patients forcibly hospitalized by regulatory authorities (compulsory measures) (7) With cardiac pacemaker or stent implantation (8) Patients with delirium (9) Patients with known brain lesions (10) Patients with known epilepsy history, having taken drugs that can cause epileptic seizures, having metal implants in the neck or brain, or having cerebral hemorrhage ，Acute phase, acute infectious diseases (11) Habitual treatment with antipsychotic drugs (12) Received antipsychotic drug treatment in the ICU before enrollment (13) Patients with severe liver dysfunction (Child-Pugh C grade) (14) Patients with severe kidney dysfunction (requiring dialysis before surgery) (15) Severe heart failure (METS \\\u003C 4) (16) Preoperative cognitive impairment as determined by a MoCA evaluation prior to surgery;\n\n\\-",{"count":251,"type":20},220,[23],"Cases were included based on the inclusion and exclusion criteria, and induction, maintenance, and recovery were conducted in accordance with the standard protocol for general anesthesia. After tracheal intubation and before tracheal tube removal at the end of the surgery, the parameters for iTBS stimulation frequency and duration were as follows: intensity was 80% of the active movement threshold, with 3 pulses per cluster at 50Hz, a frequency of 5Hz, 30 clusters of 10 pulses each, an 8 - second interval, and a single 600 - pulse; the 8 - shaped coil was connected to the electrodes in the designated head area (left frontal lobe cortex).Observation contents: Whether there is postoperative delirium and its severity: 3D - CAM assessment scale, DMAS assessment scale; awakening time, extubation time, PACU stay time, hospital stay time; 1 - 7 days after surgery or before discharge, POD assessment and pain - sleep assessment, the first time getting out of bed; postoperative complications; adverse reactions; adverse events, and so on.",[27,255,256],"Prostate Cancer","Kidney Tumor",[258,259,229],"Transcranial Magnetic Stimulation Device","elderly patients","2026-03-13",{"date":262,"type":42},"2026-03-18",{"date":264,"type":20},"2026-03-20",{"date":266,"type":20},"2028-12-01",{"name":268,"class":49},"Zhejiang University",{"id":270,"slug":271,"hasResults":11,"nctId":272,"briefTitle":273,"officialTitle":274,"acronym":4,"eligibilityCriteria":275,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":276,"enrollmentInfo":277,"targetDuration":4,"studyType":21,"phases":279,"briefSummary":280,"conditions":281,"keywords":286,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":290,"lastUpdatePostDateStruct":291,"startDateStruct":293,"completionDateStruct":295,"leadSponsor":297,"locationsCount":81},"100629597","effect-of-transcutaneous-auricular-vagus-nerve-stimulation-on-postoperative-delirium-and-negative-emotions-in-patients-undergoing-cardiac-surgery-100629597","NCT07476742","Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Delirium and Negative Emotions in Patients Undergoing Cardiac Surgery","Effect of Intraoperative Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Delirium and Negative Emotional States in Patients Undergoing Cardiac Surgery: A Multicenter, Randomized, Double-Blind, Sham-Controlled Trial","Inclusion Criteria:\n\n* Aged 18 to 85 years. Scheduled for elective cardiac surgery (e.g., CABG, valve replacement\u002Frepair). NYHA cardiac function class I-III. Willing and able to provide informed consent. Expected surgery duration ≥ 2 hours.\n\nExclusion Criteria:\n\n* Preoperative MMSE score \\\u003C 24; severe communication barriers. History of diagnosed delirium, dementia, Parkinson's disease, schizophrenia, bipolar disorder, major depressive disorder, or long-term use of psychotropic drugs.\n\nSkin lesions, infection, or deformity of bilateral ears; history of ear surgery or nerve injury; allergy to electrode materials.\n\nSevere arrhythmia; implanted electronic devices (e.g., pacemaker, ICD). Participation in another interventional trial within 3 months. Other conditions deemed unsuitable by investigators.","85 Years",{"count":278,"type":20},270,[23],"A multicenter, randomized, double-blind, sham-controlled trial to investigate the effects of intraoperative transcutaneous auricular vagus nerve stimulation (taVNS) on the incidence of postoperative delirium and negative emotional states (anxiety, depression) in patients undergoing elective cardiac surgery.",[27,282,283,284,285],"Postoperative","Anxiety","Depression","Cardiac Surgical Procedures",[287,288,229,284,283,289],"Transcutaneous Vagus Nerve Stimulation","Cardiac Surgery","Randomized Controlled Trial","2026-03-12",{"date":292,"type":42},"2026-03-17",{"date":294,"type":20},"2026-02-28",{"date":296,"type":20},"2027-02-28",{"name":298,"class":49},"Chinese PLA General Hospital",{"id":300,"slug":301,"hasResults":11,"nctId":302,"briefTitle":303,"officialTitle":304,"acronym":4,"eligibilityCriteria":305,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":306,"enrollmentInfo":307,"targetDuration":4,"studyType":21,"phases":309,"briefSummary":310,"conditions":311,"keywords":313,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":319,"lastUpdatePostDateStruct":320,"startDateStruct":322,"completionDateStruct":324,"leadSponsor":325,"locationsCount":81},"100622034","proactive-temperature-management-in-crs-hipec-for-prevention-of-delirium-100622034","NCT07378371","Proactive Temperature Management in CRS-HIPEC for Prevention of Delirium","Proactive Temperature Management and Delirium After Cytoreductive Surgery With HIPEC: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Adult patients (aged 18-80 years).\n\nAmerican Society of Anesthesiologists (ASA) physical status of I to III.\n\nScheduled for elective Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Pseudomyxoma Peritonei (PMP).\n\nWritten informed consent obtained from the participant or legally authorized representative.\n\nExclusion Criteria:\n\n* Known diagnosis of dementia, major neurocognitive disorder, or severe psychiatric illness (e.g., schizophrenia) documented in the medical record.\n\nAcute central nervous system pathology likely to confound delirium assessment (e.g., recent stroke, active seizure disorder, or traumatic brain injury).\n\nSevere sensory or language barriers precluding valid cognitive screening (e.g., profound deafness or blindness, or language barriers not correctable with translation).\n\nPreoperative coma, mechanical ventilation, or deep sedation precluding reliable baseline assessment.\n\nEmergency surgery or repeat CRS-HIPEC during the same hospital admission.\n\nHistory of alcohol or substance abuse likely to precipitate withdrawal symptoms.","80 Years",{"count":308,"type":20},174,[23],"This randomized controlled trial evaluates the efficacy of a proactive Goal-Directed Temperature Management (GDTM) protocol in reducing postoperative delirium among patients undergoing Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for pseudomyxoma peritonei.\n\nCRS-HIPEC presents a unique physiological challenge characterized by a biphasic thermal trajectory: potential hypothermia during extensive surgery followed by rapid iatrogenic hyperthermia during perfusion. This study compares a standardized GDTM strategy-which incorporates strict normothermia maintenance and anticipatory pre-cooling prior to perfusion-against standard reactive thermal management. The primary objective is to determine if optimized thermoregulation can attenuate thermal variability and improve early neurocognitive recovery.",[312,27],"Pseudomyxoma Peritonei",[314,315,316,317,318],"Cytoreductive Surgery","HIPEC","Hyperthermic Intraperitoneal Chemotherapy","Temperature Management","Goal-Directed Therapy","2026-01-27",{"date":321,"type":42},"2026-01-30",{"date":323,"type":20},"2026-02-01",{"date":176,"type":20},{"name":326,"class":49},"Aerospace Center Hospital",{"id":328,"slug":329,"hasResults":11,"nctId":330,"briefTitle":331,"officialTitle":332,"acronym":4,"eligibilityCriteria":333,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":4,"enrollmentInfo":334,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":336,"conditions":337,"keywords":341,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":346,"lastUpdatePostDateStruct":347,"startDateStruct":349,"completionDateStruct":351,"leadSponsor":353,"locationsCount":81},"100617905","impact-of-intraoperative-hemodynamic-instability-on-outcomes-in-cardiac-surgery-100617905","NCT07324694","Impact of Intraoperative Hemodynamic Instability on Outcomes in Cardiac Surgery","Impact of Intraoperative Hemodynamic Instability on Postoperative Major Adverse Events in Cardiac Surgery Patients: A Prospective Cohort Study","Inclusion Criteria:\n\n* Patients aged 18 years or older.\n* Scheduled for elective cardiac surgery (CABG, Valve replacement\u002Frepair, or combined procedures).\n* Surgery performed under cardiopulmonary bypass (CPB).\n* Preoperative sinus rhythm.\n* Signed informed consent form.\n\nExclusion Criteria:\n\n* Emergency or salvage surgery.\n* Off-pump coronary artery bypass grafting.\n* Preoperative mechanical circulatory support (IABP, ECMO) requirement.\n* Pre-existing chronic renal failure requiring dialysis (HD\u002FPD).\n* Pre-existing cognitive impairment, dementia, or history of psychiatric disorders affecting cooperation.\n* Pregnancy.",{"count":335,"type":20},230,"Intraoperative hemodynamic instability (IOHI) is a common occurrence during cardiac surgery and is associated with organ hypoperfusion. However, the specific impact of IOHI on composite adverse outcomes remains unclear. This prospective cohort study aims to evaluate the association between intraoperative hemodynamic instability (defined as MAP \\\u003C 65 mmHg or vasopressor requirement) and major postoperative complications (Delirium, Acute Kidney Injury, Stroke, or Mortality) in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass.",[288,338,339,340,27],"Intraoperative Hemodynamic Instability","Postoperative Complication","Acute Kidney Injury",[342,343,344,345],"Intraoperative Hypotension","Cardiopulmonary Bypass","Mean Arterial Pressure","Cohort Study","2026-01-09",{"date":348,"type":42},"2026-01-12",{"date":350,"type":42},"2025-04-26",{"date":352,"type":20},"2026-02-05",{"name":354,"class":49},"Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital",{"id":356,"slug":357,"hasResults":11,"nctId":358,"briefTitle":359,"officialTitle":359,"acronym":360,"eligibilityCriteria":361,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":4,"enrollmentInfo":362,"targetDuration":364,"studyType":91,"phases":4,"briefSummary":365,"conditions":366,"keywords":370,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":379,"lastUpdatePostDateStruct":380,"startDateStruct":382,"completionDateStruct":384,"leadSponsor":386,"locationsCount":81},"100619498","genecard---the-use-of-genetic-epigenetic-metabolomic-proteomic-and-microbiotic-markers-image-and-voice-biomarker-analyses-and-pre--and-intraoperative-clinical-data---to-predict-early-complications-after-cardiac-surgery-100619498","NCT07345403","GENECARD - the Use of Genetic, Epigenetic, Metabolomic, Proteomic and Microbiotic Markers, Image and Voice Biomarker Analyses, and Pre- and Intraoperative Clinical Data - to Predict Early Complications After Cardiac Surgery.","GENECARD","Inclusion Criteria:\n\n* Adults (≥18 years old)\n* Undergoing elective cardiac surgery\n* Able and willing to provide informed consent\n\nExclusion Criteria:\n\n* Age below 18 years\n* Lack of informed consent\n* Prior or planned solid organ transplantation\n* Prior or planned bone marrow transplantation",{"count":363,"type":20},3000,"30 Days","The goal of this observational cohort study is to prove whether genetic, epigenetic, transcriptomic, proteomic, metabolomic, imaging, voice, and clinical markers can improve prediction of early complications after cardiac surgery in adult patients.\n\nThe main questions it aims to answer are:\n\nWhich biological and clinical markers are associated with: new-onset atrial fibrillation (NOAF), acute kidney injury (AKI), postoperative delirium (POD), vasoplegia, postoperative bleeding and 30-day mortality? Can combining these markers improve early prediction of postoperative complications compared with current clinical risk scores?\n\nResearchers will analyze a wide range of data collected before, during, and after cardiac surgery and compare patients who develop early complications with those who do not to identify risk factors and early biomarkers.\n\nParticipants will:\n\nProvide biological samples (blood, urine, stool) before and after surgery for genetic, epigenetic, transcriptomic, proteomic, metabolomic, microbiome, and laboratory testing.\n\nUndergo standard preoperative and intraoperative imaging and clinical assessments.\n\nAllow collection of clinical data related to postoperative outcomes (For some participants) have voice and video recordings performed to help identify early signs of postoperative delirium.\n\nThis study aims to improve early detection of postoperative complications and support development of personalized diagnostic and treatment strategies for patients undergoing cardiac surgery.",[27,367,340,368,369],"Postoperative Bleeding","Atrial Fibrillation (AF)","Vasoplegia",[288,192,371,340,229,369,372,373,374,375,376,377,378],"Atrial Fibrillation","Biomarkers","Multi-omics","Risk Prediction","Epigenetics","genetics","microbiota","metabolomics","2026-01-08",{"date":381,"type":42},"2026-01-15",{"date":383,"type":20},"2026-01-01",{"date":385,"type":20},"2029-12-31",{"name":387,"class":49},"Medical University of Gdansk",{"id":389,"slug":390,"hasResults":11,"nctId":391,"briefTitle":392,"officialTitle":393,"acronym":4,"eligibilityCriteria":394,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":4,"enrollmentInfo":395,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":397,"conditions":398,"keywords":4,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":401,"lastUpdatePostDateStruct":402,"startDateStruct":404,"completionDateStruct":406,"leadSponsor":408,"locationsCount":81},"100614868","venous-congestion-and-delirium-after-cardiac-surgery-100614868","NCT07285187","Venous Congestion And Delirium After Cardiac Surgery","Intraoperative Venous Congestion And Delirium After Cardiac Surgery: A Prospective Cohort Study","Inclusion Criteria:\n\n1. Patients scheduled to undergo elective cardiac surgery via a midline thoracic incision;\n2. ≥18 years;\n3. A preoperative MMSE score\\>23, without consciousness or language barriers, capable of cooperating with neurological examinations, cognitive function tests, and other assessments of neurological function.\n\nExclusion Criteria:\n\n1. Contraindications for TEE;\n2. Emergency cardiac surgery;\n3. Major vascular surgery;\n4. Redo cardiac surgery;\n5. Severe infection requiring continuous antibiotic therapy;\n6. Severe preoperative heart failure with left ventricular ejection fraction \\\u003C 30%;\n7. A critical preoperative state (mechanical circulatory support, extracorporeal membrane oxygenation, current renal replacement therapy, mechanical ventilation, or cardiac arrest necessitating resuscitation);\n8. Multi-organ dysfunction;\n9. Known conditions that may interfere with the assessment or interpretation of hepatic vein, portal vein blood flow (such as liver cirrhosis or portal vein thrombosis) or the renal vein blood flow (such as urinary tract obstruction);\n10. Planned cardiac transplantation or ventricular assist device implantation;\n11. Pregnancy;\n12. Insufficient ultrasonographic imaging;\n13. Restarting CPB after first CPB cessation during surgery;\n14. Requirement for cardiac assist devices (ECMO, IABP, or ventricular assist device) after CPB intraoperatively;\n15. Neurological or psychiatric diagnoses that may affect cognitive performance or cognitive testing;\n16. Documented delirium before surgery.",{"count":396,"type":20},120,"Postoperative delirium (POD) is an acute brain dysfunction characterized by inattention, impaired consciousness, and cognitive and orientation disturbances, and is a common complication after cardiac surgery. The high incidence of up to 52% of POD in cardiac surgery patients lead to a range of adverse clinical outcomes.The brain tissue is enclosed in a rigid anatomical structure; when there is an obstruction to venous return from the brain, intracranial pressure can increase, and blood supply to the brain tissue can decrease, leading to central nervous system dysfunction.\n\nSystemic venous congestion can occur when there is right heart dysfunction or excessive volume load. When right heart failure and\u002For volume overload occurs, changes in right atrial pressure are transmitted to the venous system of organs throughout the body, with dilatation of the inferior vena cava (IVC), obstruction of blood return from the hepatic, portal, and renal veins, and abnormal venous flow signals and altered ultrasound Doppler flow patterns.\n\nThe primary objective of this prospective cohort study is to explore if intraoperative systemic venous congestion is associated with POD after cardiac surgery. This study will also investigate the relationship between intraoperative systemic venous congestion and postoperative complications, and the relationship between each separate venous congestion and POD after cardiac surgery.",[399,400,27,288],"Intraoperative","Venous Congestion","2025-12-16",{"date":403,"type":42},"2025-12-23",{"date":405,"type":42},"2024-11-01",{"date":407,"type":20},"2026-10-31",{"name":409,"class":49},"Zhuan Zhang",{"id":411,"slug":412,"hasResults":11,"nctId":413,"briefTitle":414,"officialTitle":414,"acronym":415,"eligibilityCriteria":416,"healthyVolunteers":11,"sex":16,"minAge":215,"maxAge":4,"enrollmentInfo":417,"targetDuration":419,"studyType":91,"phases":4,"briefSummary":420,"conditions":421,"keywords":429,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":433,"lastUpdatePostDateStruct":434,"startDateStruct":436,"completionDateStruct":438,"leadSponsor":440,"locationsCount":81},"100568904","cognitive-impact-associated-with-surgery-for-gastric-or-esophageal-cancer-100568904","NCT06687291","Cognitive Impact Associated With Surgery For Gastric Or Esophageal Cancer","CASE","Inclusion Criteria:\n\n* Patients diagnosed with esophageal or gastric cancer, treated with (or without) chemotherapy and surgery.\n* Age ≥18 at the time for inclusion.\n* Participate on a voluntary basis and can (for any reason) end its participation during the study.\n* Capable of giving informed consent.\n\nExclusion Criteria:\n\n* Patients with preoperative cognitive dysfunction such as dementia.\n* Patients who are inoperable due to metastases.\n* Patients unable to communicate due to severely impaired hearing and\u002For - seeing.\n* Patients with ongoing drug and\u002For alcohol abuse.\n* Patients who cannot give informed consent.",{"count":418,"type":20},130,"6 Months","The primary objective of this observational study is to investigate the incidence of Post Operative Delirium (POD) after gastroesophageal cancer surgery. Secondary objectives are to investigate the relationship between POD, preoperative depression, frailty, quality of life, malnutrition and sarcopenia.\n\nParticipants identified with POD will be asked (at the routine follow-up meeting after surgery) to participate in an qualitative interview, in order to understand the participant's experience of postoperative delirium.\n\nThe main objective aims to answer:\n\nWhat is the incidence of POD after gastroesophageal cancer surgery.",[422,27,423,424,425,426,427,428,284],"Gastroesophageal Cancer (GC)","Quality of Life (QOL)","Frailty","Malnutrition","Sarcopenia","Chemobrain","Chemotherapy",[70,430,424,431,432,425,426,427,428],"gastroesophageal cancer","Quality of life","Preoperative depression","2025-06-28",{"date":435,"type":42},"2025-07-02",{"date":437,"type":42},"2025-02-13",{"date":439,"type":20},"2027-11-11",{"name":441,"class":49},"Karolinska Institutet",{"id":443,"slug":444,"hasResults":11,"nctId":445,"briefTitle":446,"officialTitle":446,"acronym":4,"eligibilityCriteria":447,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":448,"targetDuration":4,"studyType":21,"phases":450,"briefSummary":451,"conditions":452,"keywords":454,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":458,"lastUpdatePostDateStruct":459,"startDateStruct":461,"completionDateStruct":462,"leadSponsor":464,"locationsCount":243},"100592917","prospective-randomized-controlled-trial-of-vr-cognitive-training-in-reducing-postoperative-delirium-in-elderly-patients-with-cerebral-small-vessel-disease-undergoing-non-cardiac-surgery-100592917","NCT06999668","Prospective Randomized Controlled Trial of VR Cognitive Training in Reducing Postoperative Delirium in Elderly Patients With Cerebral Small Vessel Disease Undergoing Non-Cardiac Surgery","Inclusion Criteria:\n\nAge ≥ 65 years; Preoperative MRI diagnosis of cerebral small vessel disease (CSVD); Scheduled to undergo non-cardiac, non-intracranial procedures under general anesthesia; Expected surgery duration \\> 2 hours; ASA physical status classification: I-III; No use of cognitive-enhancing medications within 3 months prior to surgery; Willing to participate and provide written informed consent.\n\nExclusion Criteria:\n\nContraindications to cranial MRI (e.g., cardiac pacemaker, metallic implants, etc.); Patients experiencing subjective discomfort (dizziness, nausea, vomiting) during VR device adaptation; Severe visual or auditory impairment; Severe hepatic or renal dysfunction; Pre-existing neuropsychiatric disorders (schizophrenia, epilepsy, Parkinson's disease, delirium, etc.); Inability to complete preoperative neuropsychological assessments (dementia, deaf-mutism, communication disorders); History of cerebrovascular events (stroke, transient ischemic attack, etc.) within 3 months prior to surgery; Current use of sedatives\u002Fantidepressants or history of psychoactive substance abuse\u002Falcoholism.",{"count":449,"type":20},416,[23],"This clinical study investigates whether virtual reality (VR)-based cognitive training can help prevent postoperative delirium (POD) in elderly non-cardiac patients with pre-existing cerebral small vessel disease (CSVD). With the global aging population undergoing more surgical procedures, POD has emerged as a serious complication in surgical patients that can prolong hospital stays and increase the risk of developing Alzheimer's disease. The study utilizes an innovative VR system that combines eye-tracking cognitive assessment with interactive rehabilitation games to evaluate and train patients' cognitive function before non-cardiac and non-intracranial operations. Conducted at Peking University Third Hospital and First Hospital, this research specifically targets patients undergoing general surgery, orthopedic surgery and other non-intracranial\u002Fnon-cardiac procedures to determine if this technology-based intervention can effectively reduce POD incidence in this population while exploring its underlying mechanisms. The findings could lead to a practical solution for protecting cognitive health in elderly patients undergoing routine surgical procedures during recovery",[27,453],"Cerebral Small Vessel Diseases",[70,455,456,457],"cerebral small vascular disease","virtual reality","cognitive function","2025-05-22",{"date":460,"type":42},"2025-05-31",{"date":460,"type":20},{"date":463,"type":20},"2027-12-31",{"name":465,"class":49},"Peking University Third Hospital",{"id":467,"slug":468,"hasResults":11,"nctId":469,"briefTitle":470,"officialTitle":471,"acronym":4,"eligibilityCriteria":472,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":473,"targetDuration":4,"studyType":21,"phases":475,"briefSummary":476,"conditions":477,"keywords":479,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":485,"lastUpdatePostDateStruct":486,"startDateStruct":488,"completionDateStruct":490,"leadSponsor":492,"locationsCount":81},"100580974","the-effects-of-anesthesia-depth-monitoring-on-postoperative-recovery-and-cognitive-functions-in-the-geriatric-patient-population-100580974","NCT06844279","The Effects of Anesthesia Depth Monitoring on Postoperative Recovery and Cognitive Functions in the Geriatric Patient Population","Geriatrik Hasta Grubunda Anestezi Derinliği Monitörizasyonlarının Postoperatif Derlenme ve Bilişsel Fonksiyonlara Etkileri","Inclusion Criteria:\n\n* 65 years and older\n* Elective spinal surgeries\n* ASA status I-III\n\nExclusion Criteria:\n\n* Emergent surgeries\n* ASA status IV-V\n* Prediagnosed delirium and or dementia\n* Inability to give consent",{"count":474,"type":20},75,[23],"This study will be conducted on patients aged 65 and older scheduled for surgery due to lumbar or cervical disc herniation. General anesthesia is routinely used for these types of surgeries in the hospital. In patients receiving general anesthesia, anesthesia depth monitoring is performed.\n\nAs part of the study, a preoperative anesthesia evaluation will be conducted, which will include age, weight, height, comorbidities, regularly used medications, previous surgical or anesthesia experiences, nutritional habits, mental status, and daily activity levels.\n\nOn the day of surgery, upon arrival in the operating room, the following will be measured and recorded:\n\n* Blood pressure using a non-invasive blood pressure monitor\n* Heart rate and rhythm via electrocardiogram (ECG)\n* Blood oxygen level with a pulse oximeter\n* Anesthesia depth using a forehead-applied sensor\n\nAll monitoring procedures are non-invasive and painless. Following the placement of these monitoring devices and initial measurements, anesthesia induction and surgery will commence. Throughout surgery, blood pressure, heart rate, and brain activity will be continuously recorded. After the surgical procedure, anesthesia emergence and mental status will be assessed. Preoperative evaluation data and intraoperative recordings will be used solely for research purposes, with patient identity information remaining confidential.",[478,27,223],"Geriatric Patient Care Improvement",[480,481,482,483,484,70],"anaesthesia depth monitoring","geriatric","density spectral array","bispectral index","burst supression","2025-02-26",{"date":487,"type":42},"2025-02-28",{"date":489,"type":42},"2025-01-10",{"date":491,"type":20},"2025-04",{"name":493,"class":49},"Aslıhan Güleç",{"id":495,"slug":496,"hasResults":11,"nctId":497,"briefTitle":498,"officialTitle":499,"acronym":4,"eligibilityCriteria":500,"healthyVolunteers":11,"sex":16,"minAge":4,"maxAge":4,"enrollmentInfo":501,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":503,"conditions":504,"keywords":507,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":508,"lastUpdatePostDateStruct":509,"startDateStruct":511,"completionDateStruct":513,"leadSponsor":515,"locationsCount":4},"100580968","postoperative-delirium-after-intraoperative-ephedrine-versus-norepinephrine-100580968","NCT06844201","Postoperative Delirium After Intraoperative Ephedrine Versus Norepinephrine","Postoperative Delirium After Intraoperative Ephedrine Versus Norepinephrine: a Retrospective TriNetX Database Study","Ephedrine group:\n\nInclusion Criteria:\n\n* underwent surgery (CPT code 1003143)\n* administered ephedrine on the day of surgery\n\nExclusion Criteria:\n\n* received both vasopressors (ephedrine and norepinephrine) on the day of surgery.\n* patients who underwent neurology and neuromuscular surgery, cardiac surgery, and cardiac procedures\n* patients who were administered epinephrine or dopamine on the day of surgery\n* patients who were administered ephedrine or norepinephrine at any time within the 7 days following the day of surgery\n* a prior history of disorientation (ICD-10 code R41.0) or unspecified dementia (F03)\n\nNorepinephrine group:\n\nInclusion Criteria:\n\n* underwent surgery (CPT code 1003143)\n* administered norepinephrine on the day of surgery\n\nExclusion Criteria:\n\n* received both vasopressors (ephedrine and norepinephrine) on the day of surgery.\n* patients who underwent neurology and neuromuscular surgery, cardiac surgery, and cardiac procedures\n* patients who were administered epinephrine or dopamine on the day of surgery\n* patients who were administered ephedrine or norepinephrine at any time within the 7 days following the day of surgery\n* a prior history of disorientation (ICD-10 code R41.0) or unspecified dementia (F03)",{"count":502,"type":20},10000,"This retrospective study aims to investigate the effects of norepinephrine compared to ephedrine, administered on the day of surgery, on the incidence of postoperative delirium.",[505,506,27],"Ephedrine","Norepinephrine",[505,506,37],"2025-02-19",{"date":510,"type":42},"2025-02-25",{"date":512,"type":20},"2025-02-20",{"date":514,"type":20},"2025-08-01",{"name":516,"class":49},"Riverside University Health System Medical Center",{"id":518,"slug":519,"hasResults":11,"nctId":520,"briefTitle":521,"officialTitle":521,"acronym":4,"eligibilityCriteria":522,"healthyVolunteers":111,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":523,"targetDuration":4,"studyType":91,"phases":4,"briefSummary":525,"conditions":526,"keywords":4,"overallStatus":72,"whyStopped":4,"lastUpdateSubmitDate":531,"lastUpdatePostDateStruct":532,"startDateStruct":534,"completionDateStruct":536,"leadSponsor":538,"locationsCount":81},"100578985","is-the-crp-albumin-lymphocyte-cally-index-effective-in-predicting-postoperative-delirium-in-geriatric-patients-undergoing-hip-fracture-surgery-100578985","NCT06818409","Is the CRP-Albumin-Lymphocyte (CALLY) Index Effective in Predicting Postoperative Delirium in Geriatric Patients Undergoing Hip Fracture Surgery","Inclusion Criteria:\n\n* Patients aged 65 years and older who undergo surgery for femoral neck or intertrochanteric fractures\n\nExclusion Criteria:\n\n* Patients with preoperative delirium\n* Patients with preoperative dementia\n* Patients with pathological fractures\n* Patients with open fractures\n* Patients with systemic or localized infections in the fracture region during the preoperative period\n* Patients with multiple trauma\n* Patients with a BMI \\\u003C18.5 or ≥35\n* Patients with chronic organ failure\n* Patients with advanced-stage cancer",{"count":524,"type":20},100,"Introduction: Postoperative delirium (POD) is a common complication in elderly surgical patients and is significantly associated with prolonged hospital stays, cognitive impairment, functional decline, and increased mortality rates within 6 to 12 months. Its incidence has been reported to range between 10% and 70%, depending on the diagnostic criteria used, the population studied, and the type of surgical procedure performed. The incidence is particularly higher following vascular, cardiac, and hip fracture surgeries.\n\nAccording to the 2024 updated guidelines by the European Society of Anaesthesiology and Intensive Care (ESAIC), POD should be screened at least once daily for a minimum of three days, beginning in the post-anesthesia recovery unit, based on the DSM-5 criteria. POD is a complex syndrome associated with various phenotypes and is likely the result of a combination of neuroinflammatory and oxidative stress processes.\n\nCandidate biomarkers for POD include inflammatory parameters (such as interleukins, C-reactive protein \\[CRP\\], erythrocyte sedimentation rate, and CD68), dopamine receptors, norepinephrine levels, cortisol levels, genetic biomarkers (e.g., apolipoprotein E4), acetylcholinesterase levels, and albumin levels. However, systemic stress can lead to nonspecific activation of the immune system, resulting in a decrease in lymphocyte count.\n\nAlthough the relationships between CRP, albumin, and lymphocyte count with POD have been individually investigated in the literature, no study has examined the combined effect of these three parameters. Based on this, we aimed to investigate whether the CRP-Albumin-Lymphocyte (CALLY) Index, a novel index not previously reported in the literature, is effective in predicting POD in geriatric patients with hip fractures. The CALLY Index is calculated using the formula: (Albumin × Lymphocyte) \u002F (CRP × 10⁴).\n\nAim\u002FHypothesis:\n\nH₀: The CALLY Index cannot predict the risk of postoperative delirium in geriatric patients undergoing hip fracture surgery.\n\nH₁: The CALLY Index can predict the risk of postoperative delirium in geriatric patients undergoing hip fracture surgery.\n\nMaterial-Methods:\n\nThe following data will be recorded for each patient:\n\n* Demographic variables: age, sex, height, weight, and body mass index (BMI)\n* American Society of Anesthesiologists (ASA) physical status classification\n* Comorbidities and medication use\n* Smoking and alcohol consumption history\n* Preoperative laboratory parameters: obtained from the hospital information system for CALLY Index calculation\n* Perioperative variables: type and duration of anesthesia, duration of surgery, type of surgical procedure, estimated blood loss, blood product transfusion status, and occurrence of intraoperative adverse events\n* Postoperative data:\n* Ward of admission after surgery (orthopedic ward\u002Fintensive care unit)\n* Presence of delirium, assessed twice daily (morning and evening) for three days using DSM-5 criteria, starting in the post-anesthesia recovery unit\n* Occurrence of postoperative complications\n* Length of stay in the intensive care unit\n* Total hospital length of stay\n* Mortality status\n\nPatients aged 65 years and older who undergo surgery for femoral neck or intertrochanteric fractures will be included in the study. Patients with preoperative delirium, preoperative dementia, pathological or open fractures, systemic or localized infections in the fracture region during the preoperative period, or multiple trauma will be excluded. Additionally, those with a BMI \\\u003C18.5 or ≥35 chronic organ failure, or advanced-stage cancer will be excluded from the study.",[27,527,528,529,530],"Hip Fracture","CRP","Albumin","Lymphocyte","2025-02-12",{"date":533,"type":42},"2025-02-14",{"date":535,"type":42},"2025-02-06",{"date":537,"type":20},"2025-12-31",{"name":539,"class":540},"Ankara Ataturk Sanatorium Training and Research Hospital","OTHER_GOV"]