Delirium and Neuropsychological Recovery Among Emergency General Surgery Survivors
Delirium and Neuropsychological Recovery Among Emergency General Surgery Survivors (DANE)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sarah Robbins
- Phone Number: 608-265-9138
- Email: robbins@surgery.wisc.edu
Study Locations
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Illinois
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Rockford, Illinois, United States, 61104
- SwedishAmerican Hospital
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Indiana
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Indianapolis, Indiana, United States, 47405
- Indiana University
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Wisconsin
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Madison, Wisconsin, United States, 53705
- University of Wisconsin
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Madison, Wisconsin, United States, 53715
- Meriter Hospital
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Madison, Wisconsin, United States, 53718
- East Madison Hospital
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Milwaukee, Wisconsin, United States, 53226
- Medical College of Wisconsin
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult age 65 years and older
- Admitted to one of the participating hospitals
- Undergone an abdominal orthopedic, skin, or vascular surgery in an emergency or unplanned fashion
- English-speaking
- Able to provide consent or have a legally authorized representative to provide consent
- Access to a telephone or an internet connected computer or smart device
- Discharged to home or sub-acute rehabilitation
- At least one episode of delirium or subsyndromal delirium, i.e. screen positive on at least one out of the four items on the Confusion Assessment Method-ICU (CAM-ICU) in the period prior to discharge from acute care.
Exclusion Criteria:
- A self-reported diagnosis of cancer with short life expectancy
- A history of dementing illnesses and other neurodegenerative disease such as Alzheimer's disease (AD), Parkinson disease, or vascular dementia, or current prescription of anti-dementia medication, or ruled out by Functional Activities Questionnaire (FAQ) score defining dementia; a history of significant traumatic brain injury
- Acute or subacute neurologic deficit expected to prevent independent living after hospital discharge, e.g., a history of a significant traumatic brain injury
- Have any spinal cord injury with persistent neurologic deficit at the time of study enrollment
- Incarcerated or homeless at the time of study enrollment
- Acquired neurologic injury (stroke, traumatic brain injury, cerebral edema/swelling, anoxic brain injury, or any other acute/subacute severe neurologic deficit) as the admitting diagnosis or a new event during the course of hospitalization (confirmed by EMR)
- A history of bipolar disorder or schizophrenia (confirmed by EMR)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Usual Care
Participants will receive the usual rehabilitation and post-operative care.
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Physical, cognitive, and psychological assessments
Virtual visits with care coordinator to carry out an individualized recovery plan
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Experimental: DANE Recovery Model
The delivery of the model will occur in five phases that correspond to the known stages of recovery after surgery.
During the acute stage (0 - 1 month after surgery), participants will undergo the initial case review and two initial virtual visits, and the development of the recovery care plan.
During the recovery (2 - 6 months after surgery) and maintenance (7-12 months after surgery) stages, the participants will undergo the interaction phase of the DANE Recovery Model.
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Virtual visits with care coordinator to carry out an individualized recovery plan
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in overall cognitive recovery
Time Frame: Baseline, 6 months, 12 months, and 18 months
|
Change in score on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) cognitive screening assessment.
The measure consists of 12 subtests that contribute to a total score and Index scores across five domains: Immediate Memory, Visuospatial-Constructional, Language, Attention, and Delayed Memory.
Index scores are converted to age-based standard scores (Mean = 100, Standard Deviation = 15)
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Baseline, 6 months, 12 months, and 18 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Short Physical Performance Battery (SPPB)
Time Frame: Baseline, 6 months, 12 months, and 18 months
|
Change in overall physical recovery will be assessed using Short Physical Performance Battery (SPPB).
SPPB is a group of measures that combines the results of the gait speed, chair stand and balance tests, and yields a performance score of 0-12; 0-4 poor, 5-7 intermediate, 8-12 good.
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Baseline, 6 months, 12 months, and 18 months
|
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Change in overall physical recovery
Time Frame: Baseline, 6 months, 12 months, and 18 months
|
Change in overall physical recovery will be assessed using 36-Item Short Form Survey (SF-36).
SF-36 scale has eight components (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health).
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Baseline, 6 months, 12 months, and 18 months
|
|
Patient Health Questionnaire-9 (PHQ-9)
Time Frame: Baseline, 6 months, 12 months, and 18 months
|
Change in overall psychological recovery will be assessed using Patient Health Questionnaire-9 (PHQ-9).
The PHQ-9 is a nine-item depression scale with a total score from 0 to 27, with higher scores indicating greater depression.
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Baseline, 6 months, 12 months, and 18 months
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General Anxiety Disorder-7 (GAD-7) .
Time Frame: Baseline, 6 months, 12 months, and 18 months
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Change in overall psychological recovery will be assessed using General Anxiety Disorder-7 (GAD-7) to determine the impact of the intervention on participant's mood and anxiety.
The GAD-7 is a seven-item anxiety scale with a total score from 0 to 27, with higher scores indicating greater anxiety.
|
Baseline, 6 months, 12 months, and 18 months
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Ben Zarzaur, MD, University of Wisconsin, Madison
Publications and helpful links
General Publications
- Gardner L, Bylund P, Robbins S, Holler E, Shojaei F, Shojaei F, Seidman M, Holden RJ, Fowler NR, Zarzaur B, Barboi C, Boustani M. Agile monitoring dashboard for clinical research studies. Trials. 2024 Nov 29;25(1):802. doi: 10.1186/s13063-024-08646-0.
- Mohanty S, Holler E, Ortiz D, Meagher A, Perkins A, Bylund P, Khan B, Unverzagt F, Xu H, Ingraham A, Boustani M, Zarzaur B. Delirium and neuropsychological recovery among emergency general surgery survivors (DANE): study protocol for a randomized controlled trial and collaborative care intervention. Trials. 2023 Oct 3;24(1):634. doi: 10.1186/s13063-023-07670-w.
- Mohanty S, Holler E, Ortiz D, Meagher A, Perkins A, Bylund P, Khan B, Unverzagt F, Xu H, Ingraham A, Boustani M, Zarzaur B. Delirium and Neuropsychological Recovery among Emergency General Surgery Survivors (DANE): study protocol for a randomized controlled trial and collaborative care intervention. Res Sq [Preprint]. 2023 Sep 7:rs.3.rs-3185716. doi: 10.21203/rs.3.rs-3185716/v1.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Nervous System Diseases
- Mental Disorders
- Confusion
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Delirium
- Health Care Quality, Access, and Evaluation
- Investigative Techniques
- Epidemiologic Methods
- Data Collection
- Health Care Evaluation Mechanisms
- Quality of Health Care
- Public Health
- Environment and Public Health
- Surveys and Questionnaires
Other Study ID Numbers
Other Study ID Numbers
- 2022-0545
- A539714 (Other Identifier: UW Madison)
- SMPH/SURGERY/TRAUMA (Other Identifier: UW Madison)
- 1R01AG076489-01 (U.S. NIH Grant/Contract)
- Protocol Version 4/20/2025 (Other Identifier: UW Madison)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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