Systematic review and meta-analysis of risk factor for postoperative delirium following spinal surgery

Abstract

Background Postoperative delirium is a common psychiatric disorder among patients who undergo spinal surgery. The purpose of current meta-analysis was to assess the potential risk factors related to delirium in spinal surgery. Methods We searched the following databases: PubMed, EMBASE, the Cochrane Library, and Web of Science, from inception to July 2020. Two reviewers independently assessed the quality of the included studies using the previously described Newcastle-Ottawa Scale (NOS). We included spinal surgery patients who suffered with delirium or not. Stata 12.0 was used for meta-analysis. Results Thirteen trial studies that met our inclusion criteria were incorporated into the meta-analysis. Postoperative delirium was associated with an increase of the duration of hospital stay (P = 0.044) and increased perioperative readmission rate (P = 0.013) and economic costs (P = 0.002). This meta-analysis demonstrates that there were twenty-two risk factors: general characteristic: old age, female patients, history of surgery, diabetes mellitus, hypertension; preoperative data: low hematocrit, low hemoglobin, low albumin, low sodium, depression; operative data: operating time, total blood loss; postoperative data: low sodium, low hemoglobin, low hematocrit, low albumin, fever, low potassium, blood sugar, and visual analog scale (VAS). Conclusions Delirium not only prolongs the length of hospital stay, but also increases readmission rate and the economic costs. Several risk factors including old age, female patients, history of surgery, diabetes mellitus, low hematocrit, low hemoglobin, low albumin, low sodium, depression; operative data: operating time, total blood loss, low sodium, low hemoglobin, low hematocrit, low albumin, fever, low potassium, blood sugar, and VAS were significant predictors for postoperative delirium after spinal surgery.

Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis

“…Study quality was assessed by two researchers using the NOS ( 17 ), which included three aspects: object selection, comparability, and exposure/outcome assessment. NOS scores ranged from 0 to 9, and a score of 0 to 4, 5 to 6, and 7 to 9 indicated low, intermediate, and high quality, respectively, ( 18 ). The result of the assessment was cross-checked by two researchers and disagreements were resolved under discussion.…”

Preoperative Inflammatory Markers and the Risk of Postoperative Delirium in Patients Undergoing Lumbar Spinal Fusion Surgery

“…In our study, the prevalence of POD after lumbar spinal fusion surgery was 7.4%. The prevalence of POD after spinal surgery ranged from 3.8–40.4% and 0.84–27.6% in two previous meta-analyses [ 22 , 23 ]. The prevalence of POD in our study was relatively low compared to previous studies.…”

When experiencing a surgery: Gastrointestinal cancer patients’ longitudinal trajectories in psychological stress and their association with quality of recovery

“… 27 As for the clinical variables, in agreement with the existing literature, stoma, history of surgery, and preoperative insomnia were associated with DC. 8 , 19 , 45 , 46 , 47 Probably, these patients might have a poorer physical condition and recover more slowly, resulting in higher psychological stress than those without the above characteristics who underwent surgery simultaneously. 47 In addition, the results found that some modifiable psychological factors including positive coping and low illness perception were associated with RC.…”