AI-Supported, Integrative Prediction of Postoperative Delirium: Protocol for the CONFUSED Study.

作者：Katharina Rump, Hartmuth Nowak, Martin Eisenacher, Samuel Busch, Britta Westhus, Matthias Unterberg, Sara Sordon, Lars Palmowski, Andrea Witowski, Malte Bayer, Thilo Bracht, Dominik Ziehe, Michael Adamzik, Tim Rahmel, Björn Koos, Lars Bergmann, Barbara Sitek · 发表于：PubMed · 年份：2026 · DOI：10.2196/87020 · 被引用次数：1 · 研究领域：Intensive Care Unit Cognitive Disorders、Sepsis Diagnosis and Treatment、Thermal Regulation in Medicine

Background: Postoperative delirium (POD) is a frequent and serious complication in older surgical patients, characterized by acute cognitive dysfunction and fluctuating levels of consciousness. POD is associated with prolonged hospitalization, long-term cognitive decline, reduced quality of life, and increased mortality. Despite its clinical relevance, the underlying pathophysiological mechanisms remain poorly understood, and reliable biomarkers for early prediction and prevention are lacking. Objective: The CONFUSED study aims to identify molecular and clinical predictors of POD by integrating clinical data with proteomic, transcriptomic, and epigenetic analyses. The primary objective is to develop predictive models for POD using multimodal data. Secondary objectives include the identification of delirium-associated genes, proteins, and epigenetic signatures, as well as the exploration of patient subgroups at increased risk for POD. Methods: CONFUSED is a prospective observational cohort study conducted at a German university hospital. Adult patients undergoing major surgery under general anesthesia will be enrolled until 100 cases of POD have been observed, which is expected to require a total sample size of approximately 200 to 300 patients. Blood samples are collected at 4 predefined time points: before premedication, immediately after surgery, and on postoperative days 2 and 5. Samples undergo comprehensive proteomic profiling, transcriptomic analysis using RNA microarra...