Observing Cognitive Health and Delirium After Hip Replacement Surgery in Older Adults in the Czech Republic A Study on Preoperative Cognitive Screening Using the ALBA Test and Postoperative Outcomes

What this Trial Is About

Researchers are investigating the link between preoperative cognitive impairment and postoperative delirium POD in adults aged 65 and older undergoing elective total hip arthroplasty in the Czech Republic. Postoperative delirium is a common and serious complication associated with higher risks of illness, death, longer hospital stays, and lasting cognitive and functional decline. Despite recommendations, regular cognitive screening before surgery is not widely practiced. This observational study uses the ALBA test, a brief cognitive screening tool performed during the pre-anesthetic assessment, to predict the risk of POD, which will be assessed using the CAM-ICU tool for up to 72 hours after surgery. The study also examines how frailty, multiple medications, other health conditions, type of anesthesia, blood loss, medication during surgery, and postoperative complications relate to delirium. About 300-400 participants will be enrolled across seven centers, with no additional tests or changes to their standard care. Participants will undergo routine clinical care with cognitive screening before surgery and delirium monitoring after surgery. Data will be collected in an electronic system and analyzed to evaluate how well the ALBA test predicts delirium and to explore how feasible it is to include this screening in regular practice. The main outcome is the incidence of delirium within 72 hours after surgery, along with multiple secondary measures such as frailty, medication use, anemia, anesthesia type, and postoperative events. The study aims to improve preoperative evaluation and patient outcomes without adding extra procedures or biological sampling.

Orthopedic Procedures and Postoperative Delirium in Older Adults in the Czech Republic