Risk factors for postoperative delirium after gastrointestinal surgery - using randomized Phase II trial data

Kamiya, Mako; Aoyama, Toru; Kano, Kazuki; Murakawa, Masaaki; Kazama, Keisuke; Atsumi, Yoshihito; Maezawa, Yukio; Sawazaki, Sho; Numata, Masakatsu; Taguri, Masataka; Sugano, Nobuhiro; Sato, Tsutomu; Mushiake, Hajime; Yukawa, Norio; Oshima, Takashi; Masuda, Munetaka; Rino, Yasushi

doi:10.4993/acrt.26.95

Cited by 5 publications

(14 citation statements)

References 32 publications

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“…And it is related to increased short‐ and long‐term mortality and morbidity, prolonged hospital stay, cognitive impairment, memory loss and other serious surgical outcomes (Bickel et al, 2008; Inouye et al, 2016; Saczynski et al, 2012). It also adds a financial burden to patients and families (Kamiya et al, 2018). Unfortunately, the treatment of postoperative delirium remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of delirium after gastrointestinal surgery: A meta‐analysis

Wang

et al. 2022

Journal of Clinical Nursing

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Background Postoperative delirium is one of the common complications after any major surgery such as gastrointestinal surgery. And it is related to increased mortality and morbidity and other serious surgical outcomes. Aims This study aims to identify risk factors for postoperative delirium in patients undergoing gastrointestinal surgery. Materials and Methods Relevant studies published before August 2021 were searched on Pubmed, Embase and Medline. The risk of bias of included studies was assessed by Newcastle–Ottawa Scale (NOS). A random‐effects model of DerSimonian‐Laird was used to synthesise the overall ORs or RRs for all risk factors. MOOSE checklist was used to review this manuscript. Results A total of 21 studies including 6165 patients were finally included for quantitative analysis. The pooled incidence of postoperative delirium is 11% (95% CI: 9%‐15%). 16 risk factors were identified, in which age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative C‐reactive protein (CRP) levels, operation time, blood loss and perioperative blood transfusion were statistically significant while smoking, American Society of Anesthesiologists (ASA) score, performance status, diabetes and operation approach were insignificant. Discussion This meta‐analysis may provide tips for nursing staff and surgeons to design and implement prevention programmes to reduce the incidence of postoperative delirium. Conclusion Potential risk factors of delirium after gastrointestinal surgery are age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative CRP levels, operation time, blood loss and blood transfusion.

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Section: Introductionmentioning

confidence: 99%

Risk factors of delirium after gastrointestinal surgery: A meta‐analysis

Wang

et al. 2022

Journal of Clinical Nursing

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“…A total of 48 articles were included in this study (Table 1), of which 39 (81.25%) studies were cohort, [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][39][40][41][42][45][46][47][49][50][51]54,57,[59][60][61][62][63][64][65][66][67][68] and 8 (16.6%) were randomized clinical 38,43,44,48,52,53,55,58 trials (one article excluded in the late stage as it was retracted in the publisher journal).…”

Section: Discussionmentioning

confidence: 99%

“…Figure 1 depicts the flow of retrieving the articles. Twenty-three studies included samples comprised of patient with gastrointestinal (GI) cancers, 22,24,26,[28][29][30][31][32][33]35,36,39,40,42,49,50,53,55,57,58,60,65,67 seven with urological cancers, 25,27,[45][46][47]62,68 nine on various cancers, 34,38,43,48,51,52,56,59,64 three with head and neck cancers, 21,23,41 and one with gynecological, lung, oral, and brain (tumor) cancers, respectively. Of the 48 studies, 39 [21][22][23][24][25][26][27]…”

Section: Discussionmentioning

confidence: 99%

Preoperative cognitive function as a risk factor of postoperative delirium in cancer surgeries: A systematic review and meta‐analysis

Varpaei,

Robbins,

Farhadi

et al. 2024

Journal of Surgical Oncology

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Postoperative delirium (POD) after cancer surgeries can be a result of chemo brain, anesthesia, surgery duration, and preoperative cognitive impairment. Although older age and preoperative cognitive dysfunction were reported to increase the risk of POD in noncardiac surgery, the role of preoperative cognitive function and age in the development of POD after all types of cancer surgeries is not clear. This study aimed to determine the relationship between preoperative cognitive function and likelihood of POD after cancer surgeries. This study used three main online databases and followed PRISMA guidelines. English language original articles that examined preoperative cognitive function before solid tumor cancer surgery and assessed patients for postoperative delirium were included. We employed the random effect meta‐analysis method. The overall incidence of POD ranged from 8.7% to 50.9%. The confusion assessment method was the most common tool used to assess delirium. Mini‐mental state evaluation (MMSE), Mini‐cog, and Montreal cognitive assessment were the most common tools to assess cognitive function. The pooled (total observation = 4676) random effects SMD was estimated at −0.84 (95% confidence interval [CI]: −1.30 to −0.31), indicating that lower MMSE scores before surgery are associated with a higher risk of POD. The pooled (total observation = 2668) random effects OR was estimated at 5.17 (95% CI: 2.51 to −10.63), indicating preoperative cognitive dysfunction can significantly predict the occurrence of POD after cancer surgeries. In conclusion, preoperative cognitive function is an independent and significant predictor of POD after solid tumor cancer surgeries.

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“…In The outcome indicators were risk factors, and there were three kinds of them. The first kind of risk factor was self-caused, which were age [1], gender [2], and alcohol consumption [3]. The second kind of risk factor was the influence of disease, that was, the score of APACHE-II [4].…”

Section: Meta-analysis Of Gender Factorsmentioning

confidence: 99%

“…The intensive care unit (ICU) provides isolation and equipment for patients with severe illness or coma to undergo simultaneous treatment, nursing, and rehabilitation (1,2). Severe trauma, major surgery, continuous and intensive monitoring of vital indicators, and life support require ICU treatment, with patients transferred back to the general ward when their condition improves (3,4).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative delirium in ICU patients with severe illness based on systematic review and meta-analysis

Chen¹,

Wang²,

Geng³

et al. 2022

Ann Palliat Med

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Background: Meta-analysis was performed on risk factors for postoperative delirium in intensive care unit (ICU) patients to provide theoretical guidance for the prevention of postoperative delirium in ICU patients. Methods:We conducted a search of Chinese databases using a combination of "meta-analysis", "risk factors for delirium", and "ICU patients with severe illness". "Meta analysis", "Risk factors of delirium", and "ICU severe patients" were used as search terms for English databases. The quality of the literature was evaluated using RevMan 5.3 software for Cochrane reviews.Results: Ten literatures were included, and funnel plots were drawn, most of which were asymmetric and might have publication bias. However, the experimental results of each risk factor were relatively stable, so the experimental conclusions were relatively reliable. Of the 10 studies, there were 7 literatures on age factor, 95% confidence interval (CI): 2.29-9.01. There were 9 studies on gender factors, 95% CI: 0.73-1.40.There were 3 studies on drinking factors, 95% CI: −0.04 to 0.08. There were 3 studies on Acute Physiology and Chronic Health Evaluation-II (APACHE-II) scoring factors, 95% CI: 4.54-5.15. There were 4 studies on mechanical ventilation factors, 95% CI: 3.24-11.16. There were 3 studies on mechanical ventilation time factors, 95% CI: −39.92 to 154.97. There were 3 studies on sedative factors, 95% CI: 0.23-15.50.Discussion: Different risk factors can influence the incidence of postoperative delirium in ICU patients with severe illness, which provides theoretical guidance for clinical prevention of delirium incidence.

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Risk factors for postoperative delirium after gastrointestinal surgery - using randomized Phase II trial data

Cited by 5 publications

References 32 publications

Risk factors of delirium after gastrointestinal surgery: A meta‐analysis

Risk factors of delirium after gastrointestinal surgery: A meta‐analysis

Preoperative cognitive function as a risk factor of postoperative delirium in cancer surgeries: A systematic review and meta‐analysis

Risk factors for postoperative delirium in ICU patients with severe illness based on systematic review and meta-analysis

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