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Protocol for a single-centre prospective observational study of postoperative delirium following total joint arthroplasties among South East Asians
  1. Hairil Rizal Abdullah1,2,
  2. Sapphire RouXi Tan3,
  3. Si Jia Lee1,
  4. Hamid Rahmatullah Bin Abd Razak4,
  5. Rachel Huiqi Seet1,
  6. Hao Ying5,
  7. Ervin Sethi4,
  8. Eileen Yilin Sim1
  1. 1 Department of Anesthesiology, Singapore General Hospital, Singapore
  2. 2 Duke-NUS Medical School, Singapore
  3. 3 University of Cambridge, Cambridge, UK
  4. 4 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
  5. 5 Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore
  1. Correspondence to Dr Hairil Rizal Abdullah; hairil.rizal.abdullah{at}


Introduction Postoperative delirium is a serious and common complication in older adults following total joint arthroplasties (TJA). It is associated with increased risk of postoperative complications, mortality, length of hospital stay and postdischarge institutionalisation. Thus, it has a negative impact on the health-related quality of life of the patient and poses a large economic burden. This study aims to characterise the incidence of postoperative delirium following TJA in the South East Asian population and investigate any risk factors or associated outcomes.

Methods and analysis This is a single-centre prospective observational study recruiting patients between 65 and 90 years old undergoing elective total knee arthroplasty or total hip arthroplasty. Exclusion criteria included patients with clinically diagnosed dementia. Preoperative and intraoperative data will be obtained prospectively. The primary outcome will be the presence of postoperative delirium assessed using the Confusion Assessment Method on postoperative days 1, 2 and 3 and day of discharge. Other secondary outcomes assessed postoperatively will include hospital outcomes, pain at rest, knee and hip function, health-related quality of life and Postoperative Morbidity Survey-defined morbidity. Data will be analysed to calculate the incidence of postoperative delirium. Potential risk factors and any associated outcomes of postoperative delirium will also be determined.

Ethics and dissemination This study has been approved by the Singapore General Hospital Institutional Review Board (SGH IRB) (CIRB Ref: 2017/2467) and is registered on the registry (Identified: NCT03260218). An informed consent form will be signed by all participants before recruitment and translators will be made available to non-English-speaking participants. The results of this study will be presented at international conferences and submitted to a peer-reviewed journal. The data collected will also be made available in a public data repository.

Trial registration number NCT03260218.

  • postoperative
  • delirium
  • total joint arthroplasty
  • incidence

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  • Contributors HRA and SRT designed and conceptualised the study, prepared and revised the draft manuscript, approved the final manuscript for submission and were involved in statistical calculations. SJL, HRBAR, RHS, ES and EYS designed and conceptualised the study, revised the draft manuscript and approved the final manuscript for submission. HY designed and conceptualised the study, revised the draft manuscript, approved the final manuscript for submission and was involved in statistical calculations. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding Hairil Rizal Abdullah is supported by the Singhealth Duke-NUS Academic Medical Centre Nurturing Clinician Scientists Scheme Award, (12/FY2017/P1/15-A29).

  • Disclaimer Singhealth Duke-NUS Academic Medical Centre has no role in the design of this study and will not have a role in the analysis and interpretation of the results.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Singapore General Hospital Institutional Review Board (SGH IRB) (CIRB Ref: 2017/2467).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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