PERCEPT V1
Research type
Research Study
Full title
Perioperative categorisation of electroencephalography differences between hypoactive and hyperactive delirium phenotypes in patients 65 years or older presenting for major surgery
IRAS ID
296432
Contact name
David K Menon
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundations Trust & University of Cambridge
Duration of Study in the UK
4 years, 1 months, 28 days
Research summary
The stress response is part of the body’s response to surgery, and it affects all organs including the brain. The brain’s response depends on its existing function and on its ability to compensate for such changes. When a person’s ability to compensate is exhausted acute brain failure occurs and this presents physically as delirium. Delirium is an acute confusional state that affects many patients; for example, approximately 1 in 3 patients nationally following surgery for a hip fracture in 2019. If a person develops delirium, they are more likely to stay in hospital for longer and have an increased risk of several other complications. There are two types of delirium: more active (hyperactive delirium) or less active (hypoactive delirium).
The brain produces electrical activity that can be measured using an electroencephalogram (EEG), which is commonly used in anaesthesia. When delirium occurs, there are changes in the levels of chemicals that act on the brain that can be measured in a blood sample; blood biomarkers. Additionally, chemicals that control brain function are modified in your gut. This means that your diet, gut bacteria and gut proteins are important in altering the blood and subsequently brain chemical levels. There is limited evidence comparing EEG, blood biomarker and gut bacteria measures in patients with and without delirium and between delirium types.
Accordingly, the key focus is assessment of the EEG, blood biomarkers and gut bacteria to assess whether we can predict which patients will develop delirium and each delirium type. Furthermore, we will assess the links between EEG, blood biomarker and gut bacteria between patients with no delirium, delirium and between delirium types. The assessments will be performed before, during and after the operation for up to 7 days or earlier if discharged.
REC name
Wales REC 4
REC reference
21/WA/0211
Date of REC Opinion
14 Jul 2021
REC opinion
Favourable Opinion