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

2026年9月1日 更新者: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.

調査の概要

状態

招待による登録

条件

詳細な説明

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.

研究の種類

観察的

入学 (推定)

40

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Santiago Metropolitan
      • Santiago、Santiago Metropolitan、チリ、8320000
        • Hospital Clínico de la Universidad de Chile

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 高齢者

健康ボランティアの受け入れ

はい

サンプリング方法

非確率サンプル

調査対象母集団

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.

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
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.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Incidence of postoperative delirium (POD).
時間枠: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.

二次結果の測定

結果測定
メジャーの説明
時間枠
Preoperative Baseline Cognitive Status
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Ivan Plaza-Rosales, PhD、University of Chile

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年8月6日

一次修了 (推定)

2026年12月1日

研究の完了 (推定)

2027年3月1日

試験登録日

最初に提出

2026年8月3日

QC基準を満たした最初の提出物

2026年9月1日

最初の投稿 (実際)

2026年9月8日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月8日

QC基準を満たした最後の更新が送信されました

2026年9月1日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 159526

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