Assessment of Delirium in Hospitalized Patients

August 20, 2024 updated by: University of Arizona

Objective Assessment of Delirium in Hospitalized Patients

The aim of the present study is to implement a novel body-worn sensor, the ZephyrTM BioModule (the registered name for the wearable sensor device used in our study), for assessing physical activity and physiological measures in a clinical setting together with other clinical routine assessments. Investigators' specific aim is to explore whether and how specific physical activity pattern and physiological measures are associated with delirium in hospital inpatient. The ultimate goal is early detection and intervention of delirium, and better management through monitoring of activity pattern and physiological information. The ZephyrTM a U.S. FDA-approved wireless, ambulatory physiological monitoring device that consists of a data logger and transmitter unit which is attached at the location of the 5th intercostal space using a specifically designed patch (BioPatchTM) and standard ECG electrodes. The ZephyrTM is designed for long-term measurement of a patient's physical activity and physiological measures. By using the physical activity parameters and physiological measures, a specific delirium risk profile will be computed for each patient. Finally, the association of this delirium risk profile with CAM-ICU questionnaire as a gold standard will be assessed.

Study Overview

Status

Withdrawn

Conditions

Detailed Description

After obtaining written informed consent and Protected Health Information (PHI) consent, CAM-ICU (Confusion Assessment Method for the ICU) will be measured routinely by unit nurses each shift. Results will be available in the medical record. Investigators will then measure physical activity and physiological measures (e.g. ECG, heart rate, respiration rate, and body temperature) using an unobtrusive body worn sensor. This sensor will be attached to the 5th intercostal space using a specifically designed patch (BioPatchTM) to allow quantification of physical activity such as walking, standing, sitting, lying, as well as measurement of other physiological parameters. These measurements will only be available to the research team and will not be available to the nurses on the inpatient study unit. Medical history (from clinic chart) and demographic information will be obtained, such as age, gender, weight, and height as well as details (e.g. injuries, fall score and number of falls) which happened during hospital stay. The research tests consist of one core measurements and one ancillary measurements (as required) as listed below (Note - ancillary measurement may not be required for everyone).

Core measurements Assessment of physical activity and physiological measures: Patients will be asked to wear the Zephyr BioModule for a period of 24 hours to maximum stay in the hospital. The Zephyr BioModule will be attached to the patients to the 5th intercostal space using a specifically designed patch (BioPatchTM).

Ancillary Measurements Upper Extremity Test: A validated body worn sensors (LEGSys™, Biosensics LLC) will be used to evaluate upper extremity kinematics (angular velocities). This is a simple test where the patient flexes and extends their arm for 20 seconds on each arm.

Analysis plan:

To predict the risk of delirium using physical activity and physiological data, each patient participating in the study will be categorized as to presence of delirium based on CAM-ICU questionnaire. Logistic regression analysis will be used to examine the relation between each physical activity variable (e.g. lying time) and physiological measures (e.g. heart rate) with delirium risk. Firstly, univariate logistic regression, using presence of delirium as the dependent variable, will be employed to investigate the relationship of the test variables. The Odd Ratios (OR) and coefficient of determination (R2) will be calculated for each explanatory variable. Then multivariate logistic regression using stepwise-automated methods will be performed to investigate the independent effects of the physical activity variables and physiological measures in predicting delirium. Sensitivities, specificities, positive and negative predictive values of different cut-off values will be calculated for any non-categorical variable shown to have an independent effect on predicting delirium. A two-sided P-value ≤0.05 will be considered to be statistically significant. Statistical analysis will be performed using SPSS (Statistical Package for the Social Sciences) statistics 22.0 (IBM, Armonk (name of town), NY (New York), USA).

Study Type

Observational

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Arizona
      • Tucson, Arizona, United States, 85724
        • Banner University Hospital, 3 Diamond West

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

70 years and older (Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Age 70 and older; hospitalized in ICU at high-risk of delirium.

Description

Inclusion Criteria: At least one of the following:

  • Cognitive impairment,
  • UTI (urinary tract infection)
  • Pneumonia,

  • Status post hip fracture or trauma,

    ->5 medications,

  • Previous hospitalization in past 6 months

Exclusion Criteria:

  • Refusal to participate
  • Terminally ill
  • On ventilator
  • Delirium based on CAM-ICU

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Objective Assessment of Delirium in Hospitalized Patients
Time Frame: 3 years
To identify biodata (physiological measurement) patterns indicative of the 3 subtypes of delirium (hypoactive, hyperactive and mixed). To build an algorithm sensitive and specific to the diagnosis of each of the three subtypes of delirium for future integration into a delirium monitoring system capable of objective delirium diagnosis, concentrating on those patterns indicative of early identification.
3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Arizona

Investigators

  • Principal Investigator: Jane Mohler, PhD, University of Arizona

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2015

Primary Completion (Estimated)

September 1, 2017

Study Completion (Estimated)

September 1, 2017

Study Registration Dates

First Submitted

October 2, 2014

First Submitted That Met QC Criteria

October 2, 2014

First Posted (Estimated)

October 7, 2014

Study Record Updates

Last Update Posted (Actual)

August 22, 2024

Last Update Submitted That Met QC Criteria

August 20, 2024

Last Verified

May 1, 2016

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB #1409472204

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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