Clinical Research Directory

Cohort Study of Perioperative Ultrasound and Delirium Following Hip Surgery

About this study This is a single-center prospective observational cohort study involving older adults undergoing hip surgery. The investigators will collect clinical and ultrasound-related information without changing routine treatment, anaesthesia, or surgical plans. The purpose of this study is to determine whether certain bedside ultrasound measurements and blood-flow status around the time of surgery are associated with postoperative delirium and other patient outcomes. What is the aim of this study? Postoperative delirium is a state of sudden confusion that may occur after surgery in older patients. This study focuses on older patients undergoing hip orthopaedic surgery. The investigators aim to explore the relationships between peri-operative bedside ultrasound findings, hemodynamic (blood flow and circulation) status, and the occurrence of postoperative delirium. The study will focus on several ultrasound measurements, including pre-operative carotid artery plaque burden, corrected flow time of the common carotid artery (FTc), and optic nerve sheath diameter (ONSD). The investigators will assess the associations between these measurements and postoperative delirium, and will further analyse how these factors may influence postoperative prognosis and clinical outcomes. What will happen in this study? This is an observational study. No experimental drugs or treatments will be administered to participants. Standard hospital care will not be altered because of participation in this study. Participants aged 65 years or older who are scheduled for hip orthopaedic surgery will be continuously enrolled. Information will be collected in four parts: Pre-operative assessment (before anaesthesia) Bedside ultrasound scans will be performed. The investigators will assess carotid artery plaque burden, measure corrected flow time (FTc) of the common carotid artery, and measure optic nerve sheath diameter (ONSD). General background information and existing medical conditions of participants will also be recorded. Intra-operative monitoring (during surgery) The investigators will document circulation-related data, including blood pressure, heart rate, oxygen levels, type of anaesthesia, medicines administered, and surgical details, to evaluate changes in circulatory status during the operation. Post-operative assessment (after surgery) From postoperative day 1 to postoperative day 5, or until hospital discharge (whichever occurs first), staff members will assess participants daily for signs of postoperative delirium. Clinical outcome information will also be collected, including postoperative complications (such as pneumonia), pain scores, and length of hospital stay. Data analysis The investigators will analyse the collected data. The study will examine associations between peri-operative ultrasound and hemodynamic parameters and postoperative delirium. The investigators will evaluate whether these ultrasound measurements can help predict the risk of postoperative delirium and explore relationships between these measurements and postoperative clinical outcomes. Why is this research being conducted? By collecting objective peri-operative measurements, the investigators aim to clarify the relationships between these factors, postoperative delirium, and real-world clinical outcomes. Findings from this study may help clinicians better evaluate surgical risks for older adults undergoing hip surgery in the future.