Cognitive Dysfunction and Delirium After TUR-M in Elderly Patients (POCDTURMSTUD)

July 20, 2026 updated by: Eylem Yaşar, Muğla Sıtkı Koçman University

Prediction of Postoperative Cognitive Dysfunction and Delirium: A Prospective Observational Study to Develop a Risk Score in Elderly Patients Undergoing Transurethral Resection

Elderly patients undergoing transurethral resection are at increased risk of postoperative cognitive dysfunction (POCD) and delirium, which are associated with prolonged hospital stay, increased morbidity, and decreased quality of life. Identifying patients who are more likely to develop postoperative cognitive dysfunction or delirium remains a practical challenge in daily clinical practice. Better recognition of these patients may help tailor perioperative care and improve outcomes.

This prospective observational study aims to identify perioperative factors associated with POCD and delirium in elderly patients undergoing transurethral resection and to develop a clinically applicable risk prediction model. Cognitive function and delirium are assessed using the Montreal Cognitive Assessment (MoCA) and the Confusion Assessment Method (CAM).

Cognitive function and delirium will be evaluated using the Montreal Cognitive Assessment (MoCA) and the Confusion Assessment Method (CAM).

The results of this study may support clinicians in recognizing vulnerable patients earlier and may contribute to more individualized perioperative management.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Postoperative cognitive dysfunction (POCD) and delirium are frequently encountered in elderly patients after surgery and are linked to unfavorable clinical outcomes. Transurethral resection procedures, which are commonly performed in this age group, may further increase this risk due to both patient-related and perioperative factors.

In this prospective observational cohort, patients aged 65 years and older undergoing transurethral resection at Mugla Training and Research Hospital are followed to determine the incidence of POCD and delirium and to identify perioperative factors associated with their development.

Before surgery, demographic characteristics, comorbidities, frailty status, and baseline cognitive function are recorded. Baseline cognitive function is assessed using the Montreal Cognitive Assessment (MoCA). During surgery, the anesthesia technique, procedure duration, intraoperative hemodynamic changes, and perioperative events are recorded.

After surgery, cognitive function and delirium are assessed at predefined intervals using MoCA and the Confusion Assessment Method (CAM).

The primary objective is to identify factors independently associated with POCD and delirium. In addition, a prediction model is developed using multivariable logistic regression, and its performance is evaluated by receiver operating characteristic (ROC) analysis.

The results may help to better recognize patients at higher risk and support more tailored perioperative management strategies in elderly surgical populations.

Study Type

Observational

Enrollment (Estimated)

150

Contacts and Locations

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

Study Contact

Study Contact Backup

Study Locations

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

  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of patients aged 65 years and older undergoing transurethral resection at Mugla Training and Research Hospital. These patients represent an elderly surgical population at risk for postoperative cognitive dysfunction and delirium. Participants are enrolled consecutively according to eligibility criteria and followed throughout the perioperative period.

Description

Inclusion Criteria:

  • Age ≥65 years
  • Scheduled for transurethral resection procedure
  • ASA physical status I-III
  • Able to provide informed consent
  • Adequate cognitive function to complete preoperative assessment

Exclusion Criteria:

  • Pre-existing diagnosis of dementia or severe cognitive impairment (MoCA <18)
  • Severe visual or hearing impairment preventing cognitive assessment
  • History of psychiatric disease requiring antipsychotic or sedative medication
  • Neurological disorders associated with increased delirium risk (e.g., Parkinson's disease, epilepsy)
  • Inability to complete study assessments

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
Incidence of postoperative cognitive dysfunction and delirium
Time Frame: Baseline (preoperative) and postoperative days 1, 2, and 3
Postoperative cognitive dysfunction and delirium assessed using the Montreal Cognitive Assessment (MoCA) and the Confusion Assessment Method (CAM). POCD is defined as a decline in MoCA score compared with baseline, and delirium is identified based on CAM criteria.
Baseline (preoperative) and postoperative days 1, 2, and 3

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Risk factors associated with POCD and delirium
Time Frame: From baseline (preoperative) through postoperative day 3

Evaluation of perioperative variables (demographic characteristics, comorbidities, frailty status, anesthesia type, and intraoperative parameters) associated with the development of POCD and delirium.

Evaluation of perioperative variables (demographic characteristics, comorbidities, frailty status, anesthesia type, and intraoperative parameters) associated with the development of POCD and delirium.
From baseline (preoperative) through postoperative day 3
Performance of the predictive risk model
Time Frame: Through study completion (anticipated November 2026)
Assessment of the predictive model for POCD and delirium using multivariable logistic regression and receiver operating characteristic (ROC) curve analysis.
Through study completion (anticipated November 2026)

Collaborators and Investigators

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

Sponsor

Muğla Sıtkı Koçman University

Investigators

  • Principal Investigator: Eylem Yasar, MD, Muğla Training and Research Hospital

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 (Actual)

April 5, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

November 15, 2026

Study Registration Dates

First Submitted

July 13, 2026

First Submitted That Met QC Criteria

July 20, 2026

First Posted (Actual)

July 22, 2026

Study Record Updates

Last Update Posted (Actual)

July 22, 2026

Last Update Submitted That Met QC Criteria

July 20, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2436 / 2424
  • BAKIRCAY-2025-2424 (Other Identifier: Izmir Bakircay University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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