Risk factors for postoperative delirium in elderly urological patients: A meta-analysis

Hua, Yaqi; Chen, Shoulin; Xiong, Xiao-Yun; Lin, Chuyang; Li, Dongying; Tu, Ping

doi:10.1097/md.0000000000030696

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…Compared with a previous meta-analysis [ 6 ], our systematic review and meta-analysis included articles that were published within the latest 5 years and that summarized the incidence of POD after head and neck cancer surgery. The prevalence of POD varies significantly among surgical populations; for instance, the incidence of POD is reportedly 5.45 to 28.57% after urological surgery, 10.09 to 51.28% after hip fracture surgery, and 4.1 to 54.9% after cardiac surgery [ 13 , 14 , 32 ]. In our study, the incidence of POD ranged from 4.2 to 36.9% with a pooled incidence of 20% and high heterogeneity (I2 = 93.2%, P < 0.001), which was consistent with a previous meta-analysis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis

Dong,

Yu,

Jiang

et al. 2023

BMC Neurol

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Background Postoperative delirium (POD) is a frequent neurologic dysfunction that often leads to more negative outcomes. Early identification of patients who are vulnerable to POD and early implementation of appropriate management strategies could decrease its occurrence and improve patient prognosis. Therefore, this meta-analysis comprehensively and quantitatively summarized the prevalence and related predictive factors of POD in head and neck cancer surgical patients. Methods PubMed, Embase, and Cochrane Library were searched for observational studies that reported the prevalence and risk factors for POD after head and neck cancer surgery and were published from their inception until December 31, 2022. Two reviewers independently selected qualified articles and extracted data. The qualities of related papers were assessed using the Newcastle-Ottawa scale (NOS). RevMan 5.3 and Stata 15.0 were applied to analysis the data and conduct the meta-analysis. Results Sixteen observational studies with 3289 inpatients who underwent head and neck cancer surgery were included in this review. The occurrence of POD ranged from 4.2 to 36.9%, with a pooled incidence of 20% (95% CI 15–24%, I2 = 93.2%). The results of this pooled analysis demonstrated that the statistically significant risk factors for POD were increased age (OR: 1.05, 95% CI: 1.03–1.07, P < 0.001), age > 75 years (OR: 6.52, 95% CI: 3.07–13.87, P < 0.001), male sex (OR: 2.29, 95% CI: 1.06–4.97, P = 0.04), higher American Society of Anesthesiologists grade (OR: 2.19, 95% CI: 1.44–3.33, P < 0.001), diabetes mellitus (OR: 2.73, 95% CI: 1.24–6.01, P = 0.01), and history of smoking (OR: 2.74, 95% CI: 1.13–6.65, P = 0.03). Conclusions POD frequently occurs after head and neck cancer surgery. Several independent predictors for POD were identified, which might contribute to identifying patients at high risk for POD and play a prominent role in preventing POD in patients following head and neck cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis

Dong,

Yu,

Jiang

et al. 2023

BMC Neurol

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“…Delirium is a ubiquitous complication in the postoperative period [56,57]. Studies have shown that elderly hospitalized patients with hip fractures are more likely to develop delirium resulting in increased mortality [58].…”

Section: Prognosis and Complicationsmentioning

confidence: 99%

“…Cognitive impairment was present in 53.8% of postoperative delirium (POD) patients compared Open Access Journal of Neurology & Neurosurgery to 4.4% of those without delirium [60]. Other delirium-related complications include aspiration pneumonia, falls, restraint use, pressure ulcers, readmissions, hospital-acquired comorbidities, increased hospital length of stay resulting in higher morbidity and mortality, higher healthcare cost, and increased financial burden to the family and society [56,57,59,61,62]. Delirium is also a risk factor for frailty due to increased morbidities seen in delirious patients [55,58,59,63].…”

Section: Prognosis and Complicationsmentioning

confidence: 99%

An Overview of Delirium in Hospitalized Adults: Prevention, Identification, and Management

Gómez

2023

OAJNN

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Delirium is described as an acute cognitive and attentional disorder that occurs over a short period. A rigorous cognitive evaluation and an acute history of symptoms are required for a diagnosis. It affects up to 50% of hospitalized patients above 65 years of age, costing well over US$164billion in the USA and more than $182 billion in 18 different European nations combined yearly. Delirium can be prevented by taking necessary precautions. Promising preventive measures, including cognitive stimulation, early mobilization, and medication review, have shown efficacy in reducing the incidence and severity of delirium. However, further research is warranted to deepen our understanding of the intricate interplay of risk factors and to develop precise interventions for effectively preventing and managing delirium. In this comprehensive overview, we explain the significance of early recognition of delirium by identifying the signs, symptoms and how it can be prevented and treated. Specifically, searches were conducted in PubMed and Google Scholar for systematic reviews, meta-analyses, and reviews related to the above information. The pathophysiology of delirium is complex and multifactorial. Understanding the pathophysiology of delirium involves considering various contributing factors, including neurotransmitter imbalances, inflammation, oxidative stress, and neuronal network dysfunction. While several causes exist, up to 39% of delirium episodes are due to adverse drug effects. The diagnosis is based on a comprehensive assessment that integrates clinical history, physical examination, mental status examination, laboratory investigations, and, in some cases, neuroimaging. Several differential diagnoses should be considered when evaluating a patient with delirium, such as dementia, psychosis, and mood disorders. Management of delirium requires a multidimensional approach which includes addressing underlying causes, non-pharmacological and pharmacological interventions. Future research should focus on evaluating the long-term effects of different treatment modalities and identifying personalized approaches for specific patient populations.

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Risk factors for postoperative delirium in elderly urological patients: A meta-analysis

Cited by 2 publications

References 30 publications

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis

An Overview of Delirium in Hospitalized Adults: Prevention, Identification, and Management

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