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RecruitingNCT04355195Updated Aug 31, 2026

Quality Contract: Prevention of Postoperative Delirium in the Care of Older Patients (QV-POD-2)

An observational study in Delirium in Old Age, sponsored by Charite University, Berlin, Germany. Recruiting at 2 sites in Germany. Open to participants aged 70 Years and older. Per ClinicalTrials.gov, last updated 2026-08-31.

Sponsored by Charite University, Berlin, Germany · Observational

From the registry’s dates

  • Started Apr 2020; still recruiting 6 years 6 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
18,100
Ages
70 Years and older
Sex
All
01

Study summary

The project "QV-POD-2" is a prolongation based on "QV-POD-1", which was a quality contract program of the IQTIG - Institute for Quality and Transparency in Health Care. The aim is to improve inpatient care for older patients who are undergoing inpatient surgery and thus to specifically reduce the postoperative risk of delirium. This is achieved through the implementation of evidence-based and consensus-based measures to prevent postoperative delirium in a comprehensive structured concept in routine care. The transparent documentation in an electronic patient file enables the relationships between the symptoms to be depicted in accordance with the clinical circumstances and the genesis of the postoperative delirium to be recorded and treated at an early stage. The content of the additional elements from the routine data (see primary and secondary outcome measures) in QV-POD-2 is analysed internally.

Subproject Retro-Pressure started in August 2022:

Retrospective, exploratory cohort study using electronic anesthesia and hospital records from Jan 1, 2016 to Jan 1, 2020, including patients ≥70 years undergoing surgery with anesthesia. The objective is to quantify associations between intraoperative blood pressure dynamics-variability, rate of change, relative hypo-/hypertension versus baseline, and time-integrated BP (area under/above reference)-and postoperative organ dysfunction Primary endpoints: Emergence delirium incidence (PACU/ITS) based on Nu-DESC scores and CAM-ICU scores; incidence of postoperative acute renal failure (creatinine and urea levels, as well as urine output); intraoperative blood pressure variation*; intraoperative blood pressure variation rate*; intraoperative blood pressure integral* Secondary endpoints: Blood count (hemoglobin and hematocrit values); intraoperative transfusions of blood reserves Addendum from the ethics amendment vote of 25/07/2022

Subproject Delta-Scan started in August 2022:

Evaluation of brain function using "Delta Scan" Primary objective: Evaluation of the prognostic significance of Delta Scan measurements in relation to postoperative delirium Secondary objectives: Examination of the delirium-related predictive relevance of individual influencing factors (directly but also indirectly through Delta Scan values) and examination of the effect of Delta Scan measurements on standard delirium screening methods. Study and control group's Inclusion criteria: Age >= 70 years and major surgery with anesthesia; additional exclusion criterion in the control group: Inclusion in the QV-POD-1 project (receipt of postoperative preventive measures) Addendum from the ethics amendment vote of 25/07/2022

Subproject started in June,18th, 2026:

For selected patients who are scheduled to undergo a procedure in June, July, August or September 2026 as part of the QV-POD-2 study, a wristband called CardioWatch 287-2 (manufacturer: Corsano Health B.V., Wilhelmina van Pruisenweg 35, 2595 AN The Hague, The Netherlands, loaned by Medtronic, will be etsablished. For same-day surgery patients, monitoring begins before the operation and continues until discharge from the hospital. For pre-hospitalized patients, measurements can begin at least one day before surgery upon request. The recorded values include blood pressure, heart rate, heart rate variability, respiratory rate, oxygen saturation, body temperature, physical activity, and an electrocardiogram once a day.

Subproject started in July, 2026:

Economic analysis conducted by Cellogic as a contract research project-selected clinical trial data from the clinical trial database and selected data from the Institute for the Hospital Payment System (InEK), cost unit accounting, and OPS codes will be evaluated for patients form QV-POD-1

Read the detailed description

The quality contract of the Charité Universitätsmedizin Berlin QV-POD was contractually extended so that the patients of the Charité Universitätsmedizin Berlin can be offered the preventive measures for delirium for another 5 years (07/01/2023 - 06/30/2028). The continuation of the contract is referred to with the short title QV-POD-2. In terms of content, all preventive measures known from QV-POD will be continued.

02

Conditions studied

  • Delirium in Old Age

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03

In context

Delirium

933 studies on the registry are indexed under Delirium; 190 are open to participants now.

This study's planned enrollment of 18,100 is above the median of 194 across 342 observational studies indexed under Delirium.

Browse Delirium studies →

Lead sponsor

Charite University, Berlin, Germany is the lead sponsor of 857 studies on the registry; 129 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
70 Years and older
Sexes eligible
All
Sampling method
Probability sample

Study population

Patients aged ≥70 years, male and female, who are receiving surgery

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 70 years
  • male and female patients
  • Patients who are insured with BARMER, HEK, KKH, DAK, TK or hkk Health insurances
  • Patients eligible for inclusion: by the patient, preoperatively
  • Incapacitated patients for inclusion: Written by a legal representative
  • surgery (elective and not elective)

Exclusion criteria

Exclusion criteria:

  • Moribund patients
  • Not enough language skills
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
18,100 participants (estimated)
Patient registry
No

Groups and cohorts

  • Cohort before training

    500 patients should be asked to participate in the project in the phase of zero value measurement. The documentation of the routine data before the training phase relates to patients aged ≥70 years, male and female, who are undergoing surgery.

  • Cohort after training 1

    From October 1st, 2020, the documentation of the routine data will begin after the training phase: 2,500 patients in 12 months, each aged ≥70 years, male and female, who will have surgery until the end of the contract on June 30th, 2023.

  • Cohort after documentation of routine data until June 2023

    From July 1st, 2023, the documentation of the routine data will go on: 2.500 patients in 12 months, each aged ≥70 years, male and female, who will have surgery until the end of the contract on June 30th, 2028.

06

What researchers measure

Primary outcomes

  1. Sustainability of implementation rates

    QV-POD-2: Sustainability of implementation rates (=Number of patients who underwent delirium screening at least twice a day within the first three days postoperatively / Divisor = All recruited patients) of at least 80% for screening and documentation in the next five years.

    Time frame: Up to 5 years

  2. Implementation rates

    QV-POD-1: Implementation rates (=Number of patients who underwent delirium screening at least twice a day within the first three days postoperatively / Divisor = All recruited patients) of at least 60% for screening and documentation in the first year, at least 70% in the second year and at least 80% in the third year. Addendum to the primary outcome measures from the ethics amendment vote of 25/07/2022)

    Time frame: Up to 3 years

Secondary outcomes

  1. Sustainability of implementation rates

    QV-POD-2: Sustainability of implementation rates (=Number of patients who underwent delirium screening at least twice a day within the first five days postoperatively / Divisor = All recruited patients) of at least 80% for screening and documentation in the next five years

    Time frame: Up to 5 years

  2. Implementation rates

    QV-POD-1: Implementation rates (=Number of patients who underwent delirium screening at least twice a day within the first five days postoperatively / Divisor = All recruited patients) of at least 60% for screening and documentation in the first year, at least 70% in the second year and at least 80% in the third year. Addendum to the secondary outcome measures from the ethics amendment vote of 25/07/2022)

    Time frame: Up to 5 years

  3. Care level

    The care level is taken from hospital records preoperatively and postoperatively

    Time frame: Up to one year

  4. Routine laboratory

    Routine laboratory markers

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  5. Routine vital parameters

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  6. Measurement of cholinesterases

    Cholinesterases (point of care testing (POCT) measurements) are measured in the routine

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  7. Intraoperative routine data

    Time frame: Time of surgery

  8. Postoperative routine data on the ICU, in the recovery room and normal ward

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 7 days

  9. Drug administration during inpatient treatment

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  10. Routine preventive measures against delirium

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  11. Intraoperative documented peculiarities in patients with delirium

    Time frame: Time of surgery

  12. Anticholinergic drug intake

    Scale to identify the severity of anticholinergic drugs (Level 0 = no anticholinergic effect, Level 1 = mild anticholinergic effect, Level 2 = moderate anticholinergic effect, Level 3 = severe anticholinergic effect). The sum of all levels of the different drugs gives the total load. Higher total loads of anticholinergic drugs are associated with higher anticholinergic drug load. Minimum of the scale is 0. Maximum depends on the sum of each drug level. The more drugs with anticholinergic effect are taken the higher is the anticholinergic drug load.

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  13. Duration of postoperative delirium

    Duration of postoperative delirium in all postoperative patients in normal ward, intensive care unit and recovery room is measured in days (a defined day before the start of the training measures, a defined day after the completion of the training measures). Addendum to the secondary outcome measures from the ethics amendment vote of 25/07/2022)

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  14. Incidence of postoperative delirium

    Incidence of postoperative delirium in all postoperative patients in normal ward, intensive care unit and recovery room after validated delirium screening tool at two points in time (a defined day before the start of the training measures, a defined day after the completion of the training measures).

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  15. Electroencephalography (EEG) measurement

    Objective non-invasive EEG is measured intraoperatively

    Time frame: During the duration of surgery, an expected average of 2 hours

  16. Infections

    Infections according to surgical site infections (SSI) and according to the US Centers for Disease Control and Preventions (CDC).

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  17. Quality of life 1

    Health related quality of life is measured by EQ-5D-5L (Patient and Proxy 1)

    Time frame: Up to one year (18 months)

  18. Post Intensive Care Syndrome (PICS)

    The composite outcome measure "PICS" of the patient is measured according to Needham et al 2012: New or worsening physical, cognitive, and/or mental impairments that are collectively called PICS measured by Patient Health Questionnaires (PHQ-4), MiniCog, Animal Naming Test Timed Up-and-Go (TUG), Handgrip strength. The measurements will be performed, when patients present to the outpatient clinic for follow-up examinations.

    Time frame: Up to one year

  19. Postoperative complications

    To evaluate the presence or development of postoperative organ complications during inpatient care

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  20. Analgesia consumption

    Concomitant pain medication is recorded

    Time frame: Up to one year

  21. Postoperative cognitive impairment

    Telephone or Video or questionnaire Follow up is offered to every patient with POD three months and one year after their surgery intervention. The aim of Telephone or Video or questionnaire Follow up is to assess to present Neurocognitive disorder (NCD).The Follow up screening tool is based on DSM 5 diagnostic criteria for "mild cognitive disorder". If one of the diagnostic criteria applies, we recommend to visit a neuropsychologist/ memory clinic recommend to visit a neuropsychologist/ memory clinic.

    Time frame: Up to three months

  22. Depression

    Depression is measured by Patient Health Questionnaire-8 (PHQ-8).This scale encompasses eight questions, which can be answered with not at all (0), several days (1), more than half the days (2) and nearly every day (3). The score is the sum of the 8 items. The minimum score is 0 (best outcome) and the heights 24 (worse outcome).

    Time frame: Up to one year

  23. Anxiety

    Anxiety is measured by Generalized Anxiety Disorder Scale-7 (GAD-7).The Assessment method has seven items; each can be answered with not at all (0), several days (1), more than half the days (2) and nearly every day (3). The score is the sum of all items. The minimum and maximum score are 0 (better outcome) and 21 (worse outcome) respectively.

    Time frame: Up to one year

  24. Physical function

    Physical health is measured by the sum scores of the following outcome measurement instruments: Timed Up-and-Go (TUG), Handgrip Strength, 2-Minute Walk Test (2-MWT), Short Physical Performance Battery (SPPB).

    Time frame: Up to one year

  25. Intensive care unit length of stay

    Intensive care unit length of stay is measured in days

    Time frame: Participants will be followed for the duration of intensive care stay, an expected average of 2 days

  26. Hospital length of stay

    Hospital length of stay is measured in days

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  27. Pain levels 1

    Pain levels 1 are measured with Numeric Rating Scale (NRS). NRS scale's range from 0 to 10. 0: no pain; 1-3: light pain; 4-6: moderate pain; 7-10: severe pain.

    Time frame: Up to one year

  28. Pain levels 2

    Pain levels 2 are measured with Visual Analog Scale (VAS). VAS scale's range from 0 to 10. 0: no pain; 1-3: light pain; 4-6: moderate pain; 7-10: severe pain.

    Time frame: Up to one year

  29. Pain levels 3

    Pain levels 3 are measured with Assessment of pain in dementia (BESD). BESD: The focus of external observation is on the following behavioral patterns: breathing, negative vocalization, facial expression, body language, and comfort in relation to exertional pain. Observed behaviors are assigned a score from 0 to 2. The range of the score is between 0 and 10, with 10 points indicating the most pronounced pain behavior.

    Time frame: Up to one year

  30. Pain levels 4

    Pain levels 4 are measured through the use of a scale based on behaviour items, the Behavioural Pain Scale (BPS). BPS scale's range from 3 to 12; 3: no pain, high number more pain.

    Time frame: Up to one year

  31. Pain levels 5

    Pain levels 5 are measured through the use of a scale based on behaviour items, the Behavioural Pain Scale - non-intubated (BPS-NI). BPS-NI scale's range from 3 to 12; 3: no pain, high number more pain. In the BPS-NI, the BPS item "Adaptation to the Ventilator" has been replaced by "Vocalization." The BPS-NI can be used, for example, to determine pain status in conscious, delirious patients.

    Time frame: Up to one year

  32. Disability 1

    Disability 1 is measured by Instrumental activities of daily living scale.This scale has 8 categories (ability to use telephone, shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility for own medications, ability to handle finances). Each has different levels of functioning with a score assigned. The patient circles the item that most closely describes its functional level. The lowest score is 0 (better outcome) and the highest is 8 (worse outcome).

    Time frame: Up to one year

  33. Disability 2

    Disability 2 is measured by Timed up and go test.

    Time frame: Up to one year

  34. Disability 3

    Disability 3 is measured by hand grip strength test

    Time frame: Up to one year

  35. Anxiety-Score

    Faces Anxiety Scale score

    Time frame: Up to one year

  36. Sedation

    Sedation is measured with the Richmond Agitation and Sedation Scale (RASS)

    Time frame: Up to one year

  37. Person's level of consciousness

    The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviors make up the three elements of the scale: eye, verbal, and motor. A person's GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalized patients and track their level of consciousness. Lower GCS scores are correlated with higher risk of death.

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  38. Permanent medication

    Medication at three months compared to baseline is assessed.

    Time frame: Up to one year

  39. Frailty status

    Frequency of frailty is measured by modified Fried criteria (category 1 +2 = pre-frail, category 3 -5 = frail)

    Time frame: Up to one year

  40. Postoperative oral ingestion

    Ingestion is measured by the amount of fluids and solid food.

    Time frame: The participants are followed up until the end of hospital stay, an expected average of 5 days

  41. Barthelindex

    Score of the Barthel Index ranging from 0 to 100 were collected when 0 is the minimum (worst outcome) and 100 is the maximum (best outcome). Score was reported as mean score of the Barthel Index.

    Time frame: Up to one year

  42. Patient-related outcome measures (PROMS)

    Different tools and questionnaires are combined to measure Patient-related outcome.

    Time frame: Up to one year

  43. Patient-related experience measures (PREMS)

    Patient-reported experiences of health care are measured with a questionnaire.

    Time frame: Up to one year

  44. Therapy recommendations

    Therapy recommendations are documented from patient records.

    Time frame: Up to one year

  45. Survival

    Survival is measured in Patients form QV-POD-2 within 1 year; Survival is measured in patients from QV-POD-1 until 3 months (addendum to the secondary outcome measures from the ethics amendment vote of 28/08/2025) and in patients from QV-POD-2 as Interim analysis of 3-month mortality among QV-POD-2 patients from the recruitment period: July 1, 2023 - December 1, 2025, and then annually in December until the end of the study.

    Time frame: Up to one year

  46. Establish a real time patient monitoring platform of vital signs

    Continous patient monitoring of physiological data - measured by CardioWatch 287-2 during hospital stay.

    Time frame: 18.06.2026 - 15.09.2026

  47. Economic analysis

    Data from the clinical trial database and selected data from the Institute for the Hospital Payment System (InEK), cost unit accounting, and OPS codes form QV-POD-1-patients will be evaluated.

    Time frame: 01.04.2020 bis 31.12.2025

Other outcomes

  1. Preoperative routine data

    Preoperative routine data are medical history, diagnoses, medication, etc.

    Time frame: At baseline

  2. Patient-specific characteristics

    Patient-specific characteristics of patients with delirium

    Time frame: At baseline

  3. Preoperative risk score for delirium

    Development of a risk model with different influencing factors of delirium

    Time frame: At baseline

  4. Preoperative sober times

    Time frame: At baseline

07

Study locations

2 of 2 sites recruiting
  • Department of Anesthesiology and Intensive Care Medicine (CBF), Charité - Universitätsmedizin Berlin
    Berlin, 12203, Germany
    Recruiting
    • Sascha Treskatsch, MD. Prof. · Contactsascha.treskatsch@charite.de · +49 30 450 55 15 22
    • Sascha Treskatsch, MD, Prof. · Principal investigator
    • Lennart Junge, MD · Sub investigator
    • Golschan Asgarpur, MD · Sub investigator
  • Department of Anesthesiology and Intensive Care Medicine (CCM/CVK) Berlin, Carité - Universitätsmedizin Berlin
    Berlin, 13353, Germany
    Recruiting
    • Caudia Spies, MD, Pof. · Contactclaudia.spies@charite.de · +49 30 450 55 11 02
    • Claudia Spies, MD, Prof. · Principal investigator
    • Fatima Halzl-Yürek, MD · Sub investigator
    • Daniel Hadzidiakos, MD · Sub investigator
    • Laerson Hoff · Sub investigator
    • Maurice Breithaupt, MD · Sub investigator
    • Antje Kirchstein, MD · Sub investigator
    • Friedrich Borchers, MD · Sub investigator
08

References and documents

Publications

  • Yurek F, Zimmermann JD, Weidner E, Hauss A, Dahnert E, Hadzidiakos D, Kruppa J, Kiselev J, Sichinava N, Retana Romero OA, Hoff L, Morgeli R, Junge L, Scholtz K, Piper SK, Gruner L, Harborth AEM, Eymold L, Gulmez T, Falk E, Balzer F, Treskatsch S, Hoft M, Schmidt D, Landgraf F, Marschall U, Holscher A, Rafii M, Spies C. Quality contract 'prevention of postoperative delirium in the care of elderly patients' study protocol: a non-randomised, pre-post, monocentric, prospective trial. BMJ Open. 2023 Mar 6;13(3):e066709. doi: 10.1136/bmjopen-2022-066709. PubMed 36878649 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2020 (actual). Primary completion is estimated for Jun 2028, 98 months after the start.

Of 176 non-industry observational studies under Delirium, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 37. This study's planned 98 months is above that.

Counting every sponsor, half of 178 studies reached it within 20 months; a quarter within 11 and three quarters within 41.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 17, 2020
First posted
Apr 21, 2020
StartActual
Apr 20, 2020
Primary completionEst.
Jun 2028
CompletionEst.
Jun 2029
Last update
Aug 31, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 31, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04355195
Collaborators
BARMER
Responsible party
Claudia Spies (Head of the Department of Anesthesiology and Operative Intensive Care Medicine (CCM/CVK/CBF), Charite University, Berlin, Germany) — Principal investigator
First posted
Apr 21, 2020
Start date
Apr 20, 2020
Primary completion
Jun 2028 (estimated)
Completion
Jun 2029 (estimated)
Last update
Aug 31, 2026

Study contacts

Claudia Spies, MD, Prof.
Contact
claudia.spies@charite.de
+49 30 450 55 11 02
Claudia Spies, MD, Prof.
study director · Charite University, Berlin, Germany

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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