scholarly journals Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis

2019 ◽  
Vol Volume 14 ◽  
pp. 1095-1117 ◽  
Author(s):  
T.L. Janssen ◽  
A.R. Alberts ◽  
L. Hooft ◽  
Francesco U.S. Mattace-Raso ◽  
C.A. Mosk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Elective Surgery ◽  
Meta Analysis

scholarly journals Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Author(s):  
Tayler A Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients.

scholarly journals Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Author(s):  
Tayler A Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (³ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration: CRD42020171366

scholarly journals Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Tayler A. Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes. Methods We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach. Discussion Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration CRD42020171366.

scholarly journals Predictors of Postoperative Delirium in Elderly Patients Following Total Hip and Knee Arthroplasty: A Systematic Review and Meta‑Analysis

2021 ◽  
Author(s):  
Zhou Quan ◽  
Zhou Xin-feng ◽  
Zhang Jun-xin ◽  
Tian Xin ◽  
Yang Hui-lin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
Postoperative Recovery ◽  
Cochrane Library ◽  
Primary Analysis ◽  
Hip And Knee Arthroplasty ◽  
Newcastle Ottawa Scale ◽  
Potential Factors

Abstract Background: Postoperative delirium (POD) is widely reported as a very common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to a variety of adverse effects. We sought to investigate predictors of delirium after TJA.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched up to May 2020 for studies examining POD following TJA in elderly patients. Pooled odds ratio (OR) and mean difference (MD) of those who experienced delirium compared to those who did not were calculated for each variable. The Newcastle-Ottawa Scale (NOS) was used for the study quality evaluation. Results: Fifteen studies with 31 potential factors were included in the meta-analysis. In the primary analysis, 9 factors were associated with POD, comprising advanced age (MD 3.81; 95% confidence interval (CI) 1.80–5.83), dementia (OR 24.85; 95% CI 7.26–85.02), hypertension (OR 2.26; 95% CI 1.31–3.89), diabetes (OR 2.02; 95% CI 1.15–3.55), stroke (OR 14.61; 95% CI 5.26–40.55), psychiatric illness (OR 2.72; 95% CI 1.45–5.08), use of sedative-hypnotics (OR 6.42; 95% CI 2.53–16.27), lower preoperative levels of hemoglobin (MD −0.56; 95% CI −0.89–−0.22), and lower preoperative mini-mental state examination score (MD −0.40; 95% CI −0.69–−0.12). Twelve studies were included in the systematic review, of which 24 factors were additionally correlated with POD using single studies.Conclusions: We identified predictors of POD in elderly patients following TJA. These findings may be used to identify patients with a high risk of delirium who are most likely to benefit from postoperative recovery.

scholarly journals Incidence, Outcome And Risk Factors of Postoperative Delirium Subtypes, A Systematic Review And Meta-Analysis

2021 ◽  
Author(s):  
Qian Li ◽  
Jingfei Guo ◽  
Jia Shi
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Postoperative Delirium ◽  
Elective Surgery ◽  
Case Reports ◽  
Meta Analysis ◽  
Related Information ◽  
Analysis Methodology ◽  
Randomized Control ◽  
Meta Analyses

Abstract Objective: Systematic review and meta-analysis methodology was used to estimate the pooled incidence, outcome, risk factors of postoperative delirium, including three delirium subtypes: hyperactive delirium, hypoactive delirium, mixed delirium.Methonds: This systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses(PRISMA) guideline. MEDLINE、EMBASE、CENTRAL were searched for relevant studies. Thirty-two studies from 2714 searched results with 9049 patients were enrolled in this systematic review and meta-analysis. Inclusion criteria were:1) elective surgery population;2) the incidence of delirium subtypes was recorded ;3) cohort studies.;4) language restricted to English. In addition, studies that were randomized control trials (RCT), case reports, or uncertainty in the incidence of delirium subtypes were excluded. The related information was extracted by two reviewers independently.All the analyses were conducted by the STATA (Version 16.0; Stata Corporation, College Station, TX).Result: The study we have performed showed that the highest incidence of postoperative delirium was hypoactive (14%[95%CI,12-16%]), followed by hyperactive (12%[95%CI,10-14%]), and the lowest was mixed delirium(9%[95%CI,7-11%]).Conclusion : The highest incidence of postoperative delirium was hypoactive (14%[95%CI,12-16%]), followed by hyperactive (12%[95%CI,10-14%]), and the lowest was mixed delirium(9%[95%CI,7-11%]). Therefore, it is definitely necessary to update and unify the diagnosis of delirium subtypes based on current tremendous clinical research, thus controlling and adjusting the risk factors of subtypes to reduce the incidence of postoperative delirium and improve patients' prognoses.

scholarly journals Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Quan Zhou ◽  
Xinfeng Zhou ◽  
Yijian Zhang ◽  
Mingzhuang Hou ◽  
Xin Tian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
The Elderly ◽  
Cochrane Library ◽  
Primary Analysis ◽  
Hip And Knee Arthroplasty ◽  
Newcastle Ottawa Scale ◽  
Potential Factors

Abstract Background Postoperative delirium (POD) is widely reported as a common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to many adverse effects. We sought to investigate predictors of delirium after TJA. Methods PubMed, EMBASE, Cochrane Library and Web of Science were searched up to 2020 for studies examining POD following TJA in elderly patients. Pooled odds ratio (OR) and mean difference (MD) of those who experienced delirium compared to those who did not were calculated for each variable. The Newcastle-Ottawa Scale (NOS) was used for the study quality evaluation. Results Fifteen studies with 31 potential factors were included. In the primary analysis, 9 factors were associated with POD, comprising advanced age (MD 3.81; 95% confidence interval (CI) 1.80–5.83), dementia (OR 24.85; 95% CI 7.26–85.02), hypertension (OR 2.26; 95% CI 1.31–3.89), diabetes (OR 2.02; 95% CI 1.15–3.55), stroke (OR 14.61; 95% CI 5.26–40.55), psychiatric illness (OR 2.72; 95% CI 1.45–5.08), use of sedative-hypnotics (OR 6.42; 95% CI 2.53–16.27), lower preoperative levels of hemoglobin (MD − 0.56; 95% CI − 0.89−− 0.22), and lower preoperative mini-mental state examination score (MD − 0.40; 95% CI − 0.69−− 0.12). Twelve studies were included in the systematic review, of which 24 factors were additionally correlated with POD using single studies. Conclusions Strategies and interventions should be implemented for the elderly patients receiving TJA surgeries with potential predictors identified in this meta-analysis.

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