PROSEVO Trial (Propofol-Sevoflurane Delirium Target Trial Emulation)
The results of this study have significant implications for clinical practice and guideline development. The current European guideline on postoperative Delirium prevention (ESAIC 2024) explicitly identifies a lack of large, adequately powered studies comparing different anesthetic techniques and is therefore currently unable to provide clear recommendations on the selection of an optimal technique. This study will close this knowledge gap and thus support future guideline recommendations. The results could show that a particular anesthetic technique (e.g., propofol) is associated with a significantly lower risk of postoperative delirium; if so, this would have immediate implications for modifying standard anesthesia protocols in hospitals.
Furthermore, Delirium is a significant public health challenge in aging societies. With demographic aging, the number of older patients undergoing surgery is continuously increasing. The societal costs of Delirium are estimated at several billion euros per year in major industrialized nations. A reduction in the incidence of postoperative Delirium by just 10% through optimization of the anesthetic procedure would therefore have major health economic implications.
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Claudia Spies, MD, Prof.
- Phone Number: +49 30 450 55 11 02
- Email: claudia.spies@charite.de
Study Locations
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Berlin, Germany, 12203
- Recruiting
- Department of Anesthesiology and Intensive Care Medicine (CBF), Charité - Universitätsmedizin Berlin
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Principal Investigator:
- Sascha Treskatsch, MD, Prof.
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Contact:
- Sascha Treskatsch, MD. Prof.
- Phone Number: +49 30 450 55 15 22
- Email: sascha.treskatsch@charite.de
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Berlin, Germany, 13353
- Recruiting
- Department of Anesthesiology and Intensive Care Medicine Berlin
-
Principal Investigator:
- Claudia Spies, MD, Prof.
-
Contact:
- Claudia Spies, MD, Prof.
-
Sub-Investigator:
- Maximilian Markus, MD
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Sub-Investigator:
- Hannah Zoe Wurm
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Sub-Investigator:
- Nils Daum, MD
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
- Adult patients (≥18 years) at the Department of Anesthesiology and Intensive Care Medicine (CCM/CVK) and the Department of Anesthesiology and Intensive Care Medicine (CBF) at Charité,
- undergoing elective surgery under general anesthesia
- with a planned surgery duration of ≥ 30 minutes
Description
Inclusion Criteria:
- Adult patients (≥18 years) at the Department of Anesthesiology and Intensive Care Medicine (CCM/CVK) and the Department of Anesthesiology and Intensive Care Medicine (CBF) at Charité,
- undergoing elective surgery under general anesthesia
- with a planned surgery duration of ≥ 30 minutes
In addition, the following conditions must be met:
- The surgery must be the patient's first surgery per hospital stay to avoid dependencies and repeated measurements of the same person within a short time frame;
- The surgeries take place at Charité between January 1, 2011, and December 31, 2025.
Exclusion Criteria:
Patients in any of the following situations are excluded:
- Cardiac surgery (this patient group requires specialized monitoring strategies and has postoperative delirium risk profiles that differ significantly from those of other types of surgery)
- preoperatively diagnosed delirium, defined as positive results on the Nursing Delirium Screening Scale (NU-DESC) or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) during preoperative evaluations;
- severe preoperative cognitive impairment, defined as a Mini-Mental State Examination (MMSE) score <15 points, or
- preoperatively documented severe dementia
- neurosurgical procedures (neurosurgical patients require specialized monitoring protocols and differ from other surgical patients in their postoperative delirium (POD) symptoms)
- Patients who were already admitted to intensive care units prior to their elective surgery (these patients already have increased mortality and a different risk profile)
- Patients who were already intubated or sedated prior to surgery (this group cannot undergo standardized POD screening)
- High preoperative risk for postoperative nausea and vomiting (PONV) (specifically, patients with documented PONV grade 3 or PONV grade 4 risk are excluded, as this group is indicated for anesthesia with propofol)
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of postoperative delirium I
Time Frame: 01.01.2011 - 31.12.2025
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The occurrence of postoperative delirium (yes/no) within the 5-day follow-up period, defined as a positive NU-DESC or CAM-ICU test result on at least one day of hospitalization.
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01.01.2011 - 31.12.2025
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of postoperative delirium II
Time Frame: 01.01.2011 - 31.12.2025
|
Incidence of postoperative delirium specifically in the recovery room
|
01.01.2011 - 31.12.2025
|
|
Delirium severity
Time Frame: 01.01.2011 - 31.12.2025
|
Delirium severity according to the Delirium Detection Score (DDS)
|
01.01.2011 - 31.12.2025
|
|
Duration of delirium
Time Frame: 01.01.2011 - 31.12.2025
|
Number of days with positive delirium screening results
|
01.01.2011 - 31.12.2025
|
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Time to first occurrence of postoperative delirium
Time Frame: 01.01.2011 - 31.12.2025
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Time to first occurrence of delirium in days after surgery
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01.01.2011 - 31.12.2025
|
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Length of hospital stay
Time Frame: 01.01.2011 - 31.12.2025
|
Length of hospital stay in days
|
01.01.2011 - 31.12.2025
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Unplanned intensive care unit admission
Time Frame: 01.01.2011 - 31.12.2025
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Unplanned ICU admission by hospital records
|
01.01.2011 - 31.12.2025
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30-day mortality
Time Frame: 01.01.2011 - 31.01.2026
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30-day mortality by hospital records
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01.01.2011 - 31.01.2026
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Claudia Spies, MD, Prof., Charite University, Berlin, Germany
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
Other Study ID Numbers
Other Study ID Numbers
- PROSEVO
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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