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Postoperative DeliriumNCT06445153

Digitalized Clinical Decision Support for the Prevention of Postoperative Delirium (POD)

A study testing Intervention with clinical decision support system in people with Postoperative Delirium, run by Charite University, Berlin, Germany at 4 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The project aims to improve patient safety, reduce barriers to the implementation of current guideline recommendations, reduce workload in clinics, increase efficiency in work processes and close gaps in care. Subprojects regarding delirium are implementes as well. Read more about this study

Who is it for?
Ages 70 years and older
Conditions the study is for
Postoperative Delirium
What is being tested?
Intervention with clinical decision support system
Could I receive a placebo?
No, everyone receives an active treatment
How many people
844 participants
Where
4 sitesGermany
Study dates
3 Jun 2024to 30 Jun 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 70 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Age ≥ 70 years
  • Male and female patients
  • Patients who are insured through statutory health insurance
  • Patients capable of giving consent for inclusion: by the patient, preoperatively
  • Patients under guardianship for inclusion: written declaration of consent by guardian
  • Operation (elective)
Show all 10Show fewer
  • Age ≥ 18 years
  • Male and female relatives
  • Relatives capable of giving consent for inclusion
  • All inpatients ≥ 18 years of age who have undergone delirium screening with a validated delirium screening instrument

Who cannot join

  • Insufficient language skills
  • Moribund patients
  • Study relatives
  • Insufficient language skills
  • No consent for data entry
  • Substudy of the Charité - University Berlin:

Trial locations and contacts

4 sites in 1 country.

Germany4 sites
  • Institut für Anästhesiologie und Schmerztherapie-Herz- und Diabeteszentrum NRW- Universitätsklinik der Ruhr-Universität Bochum

    Bad Oeynhausen, Bochum, 32545

  • Department of Anaesthesiolgy and Intensive Care Medicine CCM/CVK, Charite- University Berlin

    Berlin, 13355

  • CARITAS Klinik Maria Heimsuchung

    Berlin

  • Klinikum im Friedrichshain - Vivantes - Netzwerk für Gesundheit GmbH

    Berlin

Other trials in Germany

About this study

The project aims to improve patient safety, reduce barriers to the implementation of current guideline recommendations, reduce workload in clinics, increase efficiency in work processes and close gaps in care. Subprojects regarding delirium are implementes as well.

Read the detailed description

Postoperative delirium (POD) is the most common post-operative complication in the 70+ age group, affecting approximately fifteen percent of elderly patients. POD is characterized by impaired attention, awareness, and cognitive function. Both patients and their families are severely affected by the effects of this condition. While symptoms of POD occur during hospitalization, they have a critical impact on post-hospitalization quality of life, dependency on long-term care, and life expectancy.

The overarching goal of the Digi-POD project consortium is to develop a digital decision support system that makes current evidence-based guideline recommendations for POD machine-readable and allows automated, real-time validation against clinical data.

Sub-projects such as a point prevalence analysis on the incidence of delirium on 2 days at the Charité and a staff survey conducted by Aktionsbündnis Patientensicherheit e.V. in all study centers accompany this study.

Further substudies initiated by Charité Universitätsmedizin Berlin:

Two substudies (one feasibility study and one acceptance study) will be conducted using the prototype of the Clinical Brain Protection (CBP) application in Digi-POD patients at Charité.

Interviews and a review of project documentation to analyze obstacles and solution strategies for implementing data security/information security will be organized by Fraunhofer Fokus. The results will be incorporated into the Data Security project report.

Being tested
Intervention with clinical decision support system
Keywords
Clinical decision support system, Delirium risk factors, recommendations, surgery
Medical subject headings
Emergence Delirium

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intervention with clinical decision support systemOther

    To this phase, patient data is automated and systematically analyzed in order to derive decision support based on current evidence and make it available to Digi-POD users (patients, relatives, nursing staff, doctors, other healthcare professionals).

Study groups in NCT06445153
Study groupRoleWhat they receive
Control phaseNo interventionControl phase: in this phase, all study patients receive the standard therapy of the respective study center.
Intervention phaseExperimentalIn this phase, the intervention with Digi-POD is made available as Clinical Decision Support System. The intervention consists of providing patients, relatives and caregivers with Digi-POD decision support for the prevention of delirium and treatment decisions for delirium in accordance with the recommendations from the guidelines in addition to the standard therapy of the respective study center.
Receives: Other: Intervention with clinical decision support system

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Guideline adherence

    Guideline adherence: proportion of guideline recommendations fulfilled per patient in the first five postoperative days. The guideline adherence rate up to postoperative day 5 (or earlier if the patient has already been discharged) is calculated as a simple division: Number of recommendations fulfilled by number of all recommendations (N=6). A guideline adherence rate of at least 4 out of 6 points (67%) per patient is considered clinically sufficient.

    Measured: Up to five days

  2. Postperative delirium- free days

    Number of postoperative delirium- free days within 5 days postoperatively per patient.

    Measured: Up to five days

Secondary outcomes (50)
  1. Causes of delirium

    Causes of postoperative delirium- within 7 days postoperatively per patient.

    Measured: Up to seven days

  2. Changes of Electroencephalography

    Signals are measured by Electroencephalography Monitor.

    Measured: Participants will be followed up until the end of the operation, an expected average of 60 minutes

  3. Blood pressure

    Blood pressure is measured in millimeters of mercury. Drop in blood pressure, Digi-POD cutoff RR systolic below 20% of baseline from start of surgery to discharge ICU.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  4. Pulse

    Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions of the heart per minute.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  5. Heart rhythm

    Heart rhythm is measured by an electrocardiogram used to evaluate heart frequencies.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  6. Heart rate

    Heart rate is measured by an electrocardiogram used to evaluate the heart. Heart rate drop Digi-POD cutoff below 50 bpm from start of surgery to discharge ICU.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  7. Oxygen saturation

    Oxygen saturation is measured by pulse oximetry.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  8. Amount of dexmedetomidine

    If dexmedetomidine is administered by the attending physician, the information from the patient's dexmedetomidine medication chart is recorded.

    Measured: Participants will be followed up until the end of intensive care unit stay, an expected average of 3 days.

  9. Therapeutic measures against postoperative delirium (POD)

    Multicomponent/multimodal preventive measures to avoid POD are recorded by a questionnaire.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  10. Team meetings on postoperative delirium (POD)

    Multicomponent team meetings to discuss preventive measures to avoid POD will be recorded by a questionnaire.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  11. Delirium incidence

    Delirium incidence is measured with validated delirium scores.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  12. Delirium duration

    Delirium duration is measured in days.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  13. Proportion of patients with adequate adherence

    Proportion of patients with adequate (at least 4 out of 6 points) adherence to guidelines.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  14. Proportion of patients with good adherence

    Proportion of patients with good (at least 5 out of 6 points) adherence to guidelines

    Measured: Up to 7 postoperative days

  15. Number of POD-free days in patients who achieved less than 80% adherence to the guidelines.

    Number of POD-free days in patients who achieved less than 80% adherence to the guidelines.

    Measured: Up to 7 postoperative days

  16. Guideline adherence

    Percentage of guideline recommendations fulfilled per patient in the first 7 postoperative days.

    Measured: Up to 7 postoperative days

  17. Number of POD-free days within 7 days

    Number of POD-free days within 7 days is measured postoperatively per patient:in

    Measured: Up to 7 postoperative days

  18. Delirium incidence within 7 days

    Delirium incidence in patients who received delirium screening with validated delirium scores twice a day in at least two shifts (per-protocol analysis)

    Measured: Up to 7 postoperative days

  19. Anxiety

    Anxiety is measured by Faces Anxiety Scale

    Measured: Up to 5 postoperative days

  20. Pain

    Pain is measured with validated pain scores, scoring form 0 (no pain) to 10 (highest pain).

    Measured: Up to 5 postoperative days

  21. Depth of sedation

    Depth of sedation is measured with the Richmond Agitation-Sedation Scale (RASS)

    Measured: Up to 5 postoperative days

  22. Functional performance

    Functional performance is measured with the Glagow Coma Scale

    Measured: Up to 5 postoperative days

  23. Concomitant medication

    Concomitant medication is measured in dosis per day.

    Measured: Up to 5 postoperative days

  24. Complications

    Postoperative procedures/therapies and complications classified according to Clavien-Dindo

    Measured: Up to 7 postoperative days

  25. Infection status

    Infection status is measured by chart review

    Measured: Up to 7 postoperative days

  26. Charlson comorbidity index (CCI)

    The total score in the CCI is derived by summing the assigned weights of all comorbid conditions presented by the client. Higher scores indicate a more severe condition and consequently, a worse prognosis.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  27. Change in cognitive status I

    Cognitive status is measured with validated scores.

    Measured: Up to 6 months

  28. Change in cognitive status II

    Cognitive status is measured with the MOCA in patients with positive and negative MiniCog.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  29. Change in care level for BARMER patients

    Care level is measured by chart review.

    Measured: Up to 6 months

  30. Change in utilization of inpatient care

    Measured: Up to 6 months

  31. Change in Patient-Reported Outcomes Measures (PROMs)

    Patient-Reported Outcome Measures are recorded by PROM instruments.

    Measured: Up to 3 months

  32. Change in Patient-Reported Experience Measures (PREMs)

    Patient-Reported Experience Measures are recorded by PREM instruments.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  33. Change in the result from the detailed geriatric assessment and the frailty scoring

    Frailty is measured by a modified Fried score.

    Measured: Up to 6 months

  34. Length of hospital stay

    Length of hospital stay is measured in days.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  35. Length of intensive care unit stay

    Length of intensive care unit stay is measured in days.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  36. Discharge type

    Discharge type is taken from the medical record.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  37. Length of stay in the recovery room

    Length of stay in the recovery room is measured in hours.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  38. Duration of surgery

    Duration of surgery is measured in minutes.

    Measured: Participants will be followed up until the end of operation, an expected average of 2 hours

  39. Duration of anesthesia

    Duration of anesthesia is measured in minutes.

    Measured: Participants will be followed up until the end of operation, an expected average of 2 hours

  40. Recommended therapies

    Recommended therapies (physiotherapy, memory consultation, nutritional counseling) are measured by physical assessments.

    Measured: Up to 6 months

  41. Incidence of Post Intensive Care Syndrome (PICS)

    Incidence of Post Intensive Care Syndrome (PICS) is measured by a composite of psychological, cognitive and functional scores.

    Measured: Up to 3 months

  42. Social data/Paragraph 21 data

    Health economic data according to cost of patient care (The §21 dataset (diagnoses and operation-codes).

    Measured: Up to 6 months

  43. Social data

    Evaluation of social data (pseudonymised) only for patients with statutory BARMER insurance and only with the patient's written consent to the processing of social data.

    Measured: Up to 6 months

  44. All-cause "mortality"

    Mortality is measured inhospital and during ths FU phase.

    Measured: Up to 6 months

  45. Direct cost data

    Direct care costs during inpatient treatment from the perspective of SHI (statutory health insurance).

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  46. Follow-up costs

    e.g. for outpatient/inpatient treatment, medication, remedies/aids and long-term care) from the perspective of statutory health insurance (SHI) and statutory long-term care insurance (LTCI)

    Measured: Up to 6 months

  47. Utilization of benefits

    Utilization of benefits from (statutory health insurance) (SHI) and statutory long-term care insurance (GPV) (in particular need for long-term care, outpatient/inpatient treatment)

    Measured: Up to 6 months

  48. Personnel resources during the hospital stay

    Personnel resources are measured by commitment time

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  49. Investment costs

    Costs are calculated with project data.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

  50. Maintenance costs

    Costs are calculated with project data.

    Measured: Participants will be followed up until the end of hospital stay, an expected average of 7 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2024
  2. Study start3 Jun 2024
  3. Primary completion15 Jan 2026
  4. Study completion30 Jun 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Sequential
Model description
Digi-POD is a multicenter, prospective, longitudinal intervention study in a before-and-after design with quantitative process analysis
Masking
None (open label)
Enrolment
844 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06445153
Sponsor's protocol ID
Digi-POD
Status last verified
Oct 2026
First submitted
23 May 2024
Last updated
23 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Intervention with clinical decision support system in people with Postoperative Delirium, run by Charite University, Berlin, Germany at 4 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Guideline adherence (time frame: Up to five days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Oct 2026.

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