Exploring relationship between sleep monitoring parameters, through wearables, and delirium score in elderly patients hospitalized for hip fracture

Delirium occurs in 25% to 61.3% of geriatric hip fracture patients, depending
on the measurements methods and criteria used (Brännström et al., 1989; Milisen
et al., 2001; Williams et al., 1985) and is associated with two to five times
higher mortality risk (Tess, 1991). Early recognition of delirium and treatment
of older hip fracture patients has been shown to affect its severity and its
duration (Milisen et al., 2001) and may contribute to a positive clinical
outcome (Cole et al., 1994; Williams et al., 1979). A possible link between
delirium and sleep disturbances has been hypothesized in terms of a common
pathophysiologic pathway, shared mechanisms, and a potential cause-effect
relationship (Figueroa-Ramos et al., 2009). In addition sleep tracking with
wearables has been introduced and gone through verification and validation,
however within a healthy population (de Zambotti et al., 2016, 2018; Washington
et al., 2016). This research hypothesizes the ability of wearable sleep
tracking to improve hospital care among elderly hip fracture patients.
Moreover, sleep disturbances for whatever cause may point into the direction of
delirium caused by numerous possible stressors. This study aims to detect
differences of sleeppatterns which correlate with clinical outcome measures,
i.e. DOS (Delirium Observation Screening) scoring (Scheffer et al., 2011*
Schuurmans et al., 2003) of delirium in hip fracture patients (80+).

The primary objective is to explore whether sleep monitoring data correlate
with DOS score in patients admitted for hip fracture.

This study is an exploratory prospective trial, aiming to explore the
relationship between sleep monitoring data and DOS score. The sleep monitoring
data and delirium score of the eligible patients will be registered during
their hospital stay. The sleep data will be collected by means of a wearable
bracelet and the delirium status will be scored with the DOS score. The DOS
will be applied three times a day, at each shift, by qualified nurses.
Potential relationship between sleep monitoring parameters and DOS scores will
be assessed by applying correlation and regression methods (linear mixed
models) on the collected data.

The patient will be supplied with a tracking device at the wrist. A so-called
Fitbit Charge 3 tracker with a display of a clock. The tracking devices will be
disinfected before use. There is no risk of harm by wearing this measurement
device.