Orthopedic Procedures and Postoperative Delirium in Older Adults in the Czech Republic

Recruiting now

Conditions studied: Frailty, Cognitive Impairment, Older Adults, Hip Arthroplasty, Postoperative Delirium

In brief

This multicenter, prospective, non-interventional observational study (ORTOPODCZ) investigates the association between preoperative cognitive impairment and postoperative delirium (POD) in older adults undergoing elective total hip arthroplasty in the Czech Republic. Postoperative delirium is a frequent and serious neurocognitive complication in senior surgical patients and is associated with increased morbidity, mortality, prolonged hospitalization, and impaired functional and cognitive outcomes. Despite international recommendations, routine preoperative cognitive screening remains insufficiently implemented. The study evaluates the predictive value of the ALBA test, a brief cognitive screening tool, performed during the pre-anesthetic assessment. Postoperative delirium will be assessed using the validated CAM-ICU instrument for up to 72 hours after surgery. Secondary objectives include assessing the relationship between POD and frailty, polypharmacy, comorbidities, type of anesthesia, intraoperative hemodynamics, blood loss, vasoactive support, and postoperative complications. Approximately 300-400 participants aged ≥65 years will be enrolled across seven centers. No additional procedures, biological sampling, or deviations from standard clinical care are required. Data will be collected in REDCap and analyzed according to a predefined statistical analysis plan. The study aims to provide robust evidence supporting the integration of cognitive screening into routine preoperative evaluation and to describe feasibility and implementation requirements for the ALBA test in clinical practice.

Key facts

Study ID

NCT07432009

Run by

Tomas Bata Hospital, Czech Republic

People needed

400

Starts

2026-04-24

Expected to finish

2030-03-31

Last updated by the study team

2026-07-09

Who can join

Age: 65 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Age ≥ 65 years
• Elective total hip arthroplasty in general or regional anesthesia
• ASA physical status I-III
• Ability to understand and cooperate during testing; no severe sensory impairment (compensatory aids allowed)
• Expected postoperative hospitalization in ICU, PACU, or standard ward

You may not qualify if…

• Glasgow Coma Scale ≤ 14
• Limited legal capacity
• Active psychiatric disorder (e.g., psychotic disorder, bipolar disorder)
• Active oncological disease
• Chronic use of strong opioids
• Premedication with anxiolytics or antipsychotics during preanesthetic evaluation
• Acute reoperation within 3 months of primary surgery
• Refusal to participate or withdrawal of consent

Where it is running

• Tomas Bata Regional Hospital — Zlín, Czechia (enrolling)
• University Hospital Olomouc - Department of Anaesthesiology, Resuscitation and Intensive Care — Olomouc, Czechia
• University Hospital Ostrava - Department of Anaesthesiology, Resuscitation and Intensive Care — Ostrava, Czechia
• University Hospital Brno - Bohunice — Brno, Czechia
• University Hospital Motol — Prague, Czechia
• Vsetín Hospital — Vsetín, Czechia
• University Hospital Královské Vinohrady — Prague, Czechia

Full record on ClinicalTrials.gov

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