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Eye Movements to Predict Post-Operative Delirium (EYE-POD)

1 septembre 2026 mis à jour par: Iván Plaza-Rosales, University of Chile

Predicting Post-operative Delirium Using Eye Movements: a Pilot Study

Postoperative delirium (POD) is a common complication in older adults undergoing surgery, lacking objective and noninvasive diagnostic methods. This trial aims to evaluate the feasibility and prognostic performance of Eye movements (EM) as a risk biomarker for the development of POD in older patients undergoing moderate- to high-risk surgery. The investigators hypothesize that EM tracking will accurately predict POD, potentially optimizing early intervention and patient outcomes.

Aperçu de l'étude

Statut

Inscription sur invitation

Les conditions

Description détaillée

This prospective trial evaluates the integration of automated eye movement assessments as a novel, noninvasive risk biomarker for postoperative delirium (POD) in older adults. Upon enrollment, trained clinical staff will collect baseline demographic data and clinical characteristics. Chronic medical burden will be quantified using the Charlson Comorbidity Index (CCI). To establish baseline cognitive function and control for preexisting cognitive impairment, all participants will undergo the Montreal Cognitive Assessment (MoCA).

Technical Protocol for Eye Movement Recording

Preoperatively, participants will complete an automated eye movement tracking protocol consisting of two distinct paradigms:

Prosaccadic Task: Utilized to measure specific ocular motor parameters, including saccadic latency, velocity, and accuracy.

Free Visual Exploration Task: Utilized to capture free-gaze metrics and spatial distribution patterns.

All eye-tracking data will be recorded using automated software to ensure objectivity and reproducibility.

Postoperative Monitoring Following the surgical procedure, patients will be systematically monitored for the development of POD. The Confusion Assessment Method (CAM) will be administered by trained examiners twice daily (morning and evening) for the first three postoperative days (72 hours) to detect and document the incidence and severity of delirium.

Statistical and Predictive Objectives

The collected data will be analyzed to fulfill three primary scientific objectives:

  1. Parameter Association: To identify which specific preoperative eye-tracking metrics (latency, velocity, accuracy, or free-gaze variables) demonstrate a statistically significant association with the incidence of POD.
  2. Diagnostic Performance: To calculate the sensitivity and specificity of these distinct preoperative eye movement parameters for predicting POD development.
  3. Incremental Predictive Value: To evaluate whether adding preoperative eye-tracking measurements to a standard clinical prediction model (comprising age, sex, CCI, and MoCA scores) significantly improves the model's overall predictive performance and risk stratification capabilities.

Type d'étude

Observationnel

Inscription (Estimé)

40

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Chili
    • Santiago Metropolitan
      • Santiago, Santiago Metropolitan, Chili, 8320000
        • Hospital Clínico de la Universidad de Chile

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte plus âgé

Accepte les volontaires sains

Oui

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Older adult patients scheduled for moderate- to high-risk surgeries at the Hospital Clínico de la Universidad de Chile. The cohort is drawn from the elective surgical scheduling pool of the institution, aiming for a balanced distribution across biological sex and age ranges within the target demographic.

La description

Inclusion Criteria:

  • Patients aged 70 years or older.
  • Scheduled for moderate- to high-risk elective surgery, defined as a procedure requiring a postoperative hospital stay of at least 3 days.
  • Able to provide signed, written informed consent.

Exclusion Criteria:

  • Presence of delirium at baseline admission, evaluated via the Confusion Assessment Method (CAM).
  • Use of neuroleptic/antipsychotic medications within the past 6 months.
  • Prior history of dementia (including Alzheimer's disease, vascular dementia, or mild cognitive impairment).
  • History of encephalopathy.
  • Psychiatric disorders presenting with psychosis.
  • Brain injury with neurological sequelae (e.g., prior stroke, traumatic brain injury).
  • Visual acuity is insufficient to complete the automated eye-tracking tasks.
  • Illiteracy.
  • Non-Spanish speakers.
  • Concurrent participation in any other clinical trial.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
No Intervention: Control (Usual care) + Eye movement recording

This is a prospective, observational cohort study designed to evaluate the prognostic accuracy of a preoperative eye-tracking biomarker protocol for predicting postoperative delirium (POD). All eligible participants are recruited from a cohort of patients already scheduled for moderate- to high-risk elective surgery at the University of Chile Clinical Hospital.

The study procedures (baseline clinical data collection, Charlson Comorbidity Index, MoCA, and automated eye-tracking tasks) are strictly observational and diagnostic. The eye-tracking results are recorded for research purposes only and do not alter standard perioperative care, surgical management, or anesthetic techniques. Patients are subsequently followed into the postoperative period to monitor the incidence of POD via twice-daily Confusion Assessment Method (CAM) evaluations during the first three postoperative days.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Incidence of postoperative delirium (POD).
Délai: From the day of surgery up to postoperative day 3, patients were assessed twice daily.
The presence or absence of postoperative delirium will be assessed using the Confusion Assessment Method (CAM). Patients will be classified as "POD" or "No POD" based on the CAM diagnostic algorithm.
From the day of surgery up to postoperative day 3, patients were assessed twice daily.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Preoperative Baseline Cognitive Status
Délai: At preoperative baseline (day of surgery or day before).
Total score on the Montreal Cognitive Assessment (MoCA) to determine baseline global cognitive function. The score ranges from 0 to 30, with lower scores indicating greater cognitive impairment.
At preoperative baseline (day of surgery or day before).
Preoperative Comorbidity Burden
Délai: At preoperative baseline (day of surgery or day before)
Score on the Charlson Comorbidity Index (CCI) to quantify the participant's baseline medical comorbidity burden and pre-existing health conditions.
At preoperative baseline (day of surgery or day before)
Preoperative Saccadic Latency
Délai: At preoperative baseline (day of surgery or day before)
The time taken from the appearance of a visual target to the initiation of the participant's saccadic eye movement during the prosaccadic task (milliseconds).
At preoperative baseline (day of surgery or day before)
Preoperative Saccadic Velocity
Délai: At preoperative baseline (day of surgery or day before).
The peak speed of the participant's eye movement when moving towards the visual target during the prosaccadic task (degrees per second).
At preoperative baseline (day of surgery or day before).
Preoperative Free Viewing Number of Fixations
Délai: At preoperative baseline (day of surgery or day before).
The absolute count of discrete gaze fixations made by the participant during the free visual exploration task (number of fixations)
At preoperative baseline (day of surgery or day before).
Preoperative Free Viewing Saccade Length
Délai: At preoperative baseline (day of surgery or day before).
The average spatial distance between fixations in the participant's eye movements during the free visual exploration task (degrees of visual angle).
At preoperative baseline (day of surgery or day before).
Hospital Length of Stay
Délai: Up to 30 days post-surgery.
Total hospital stay from the day of surgery until official hospital discharge.
Up to 30 days post-surgery.
All-Cause Mortality
Délai: At 30 days post-surgery.
Total number of participant deaths from any cause, verified via hospital electronic medical records or direct follow-up contact.
At 30 days post-surgery.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

University of Chile

Les enquêteurs

  • Chercheur principal: Ivan Plaza-Rosales, PhD, University of Chile

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

6 août 2026

Achèvement primaire (Estimé)

1 décembre 2026

Achèvement de l'étude (Estimé)

1 mars 2027

Dates d'inscription aux études

Première soumission

3 août 2026

Première soumission répondant aux critères de contrôle qualité

1 septembre 2026

Première publication (Réel)

8 septembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

8 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

1 septembre 2026

Dernière vérification

1 juillet 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 159526

Plan pour les données individuelles des participants (IPD)

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INDÉCIS

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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