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NCT Number: NCT07719712

Cognitive Dysfunction and Delirium After TUR-M in Elderly Patients

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.

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Key information

Conditions

Postoperative Delirium Cognition Disorders Cognitive Dysfunction Confusion Delirium Emergence Delirium Mental Disorders Nervous System Diseases Neurobehavioral Manifestations Neurocognitive Disorders Neurologic Manifestations Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Cognitive Complications Postoperative Cognitive Dysfunction Postoperative Complications Signs and Symptoms

Age range

65 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Cognitive and Delirium Assessment (MoCA and CAM)

Diagnostic Test

Patients aged 65 years and older undergoing transurethral resection who are followed for the development of postoperative cognitive dysfunction and delirium.

Primary outcomes

  1. 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.

Secondary outcomes

  1. 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.

  2. 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Eylem Yasar, MD

CONTACT

[email protected]

+905332392622

Melike Korkmaz Toker, MD

CONTACT

[email protected]

+905054747098

Sponsors and collaborators

Lead sponsor

Muğla Sıtkı Koçman University

Other

Registry information

Official study title

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

Acronym: POCDTURMSTUD

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 22, 2026
Registry last updated
Jul 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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