The risk factors for postoperative delirium in adult patients after hip fracture surgery: a systematic review and meta‐analysis

Abstract

Objectives: Postoperative delirium (POD) is the most common complication in patients after hip fracture surgery, and the incidence of POD is associated with mortality and disability in patients following hip fracture surgery. Therefore, this study aimed to identify the individual as well as anesthetic and operative risk factors associated with the POD in adult patients after hip fracture surgery. Methods: We searched relevant articles published to February 2020 in Cochrane Library, PubMed, and Embase. Studies involving adult patients who underwent hip fracture surgery were regarded as relevant if the studies contained the individual or anesthetic and surgical characteristics of participants. The pooled relative risk ratios (RRs) or weight mean difference of the variables were estimated by the Mantel-Haenszel or Inverse-Variance methods. Results: A total of 44 studies were included, which altogether included 104572 participants with hip fracture surgery (17703 patients with POD and 86869 patients without POD) and the incidence of POD was 16.93%. A total of 14 risk factors, classified into two categories which were individual as well as anesthetic and operative factors, were identified originally, which included age (weight mean difference

Risk Factors and a Nomogram Model Establishment for Postoperative Delirium in Elderly Patients Undergoing Arthroplasty Surgery: A Single-Center Retrospective Study

“…Based on the propensity scores, postoperative delirium patients were matched in 1 : 1 ratio to normal patients using greedy nearest neighbor matching algorithm without replacement and match tolerance equal to 0.01. Refer to the previous study; when fitting the PSM model, 14 baseline characteristics which were proven to be risk factors of POD were used as baseline covariates to participate in the analysis: age, sex, smoking, drinking, diabetes, hypertension, coronary heart disease, history of mental illness or psychotropic drug use, blood transfusion, anesthesia, surgical approach, surgical grade, EF, and LVD [ 8 , 13 – 15 ]. Standardized differences for categorical variables before and after PSM were evaluated by chi-square, but for the continuous variable, independent T test was used.…”

Association between glaucoma surgery and all-cause and cause-specific mortality among elderly patients with glaucoma: a nationwide population-based cohort study

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High-Mobility Group Box-1 and Its Potential Role in Perioperative Neurocognitive Disorders

“…While the etiological pathways that result in PND are still not precisely known, the field has progressed since the initial reports which emphatically stated that general anesthetics were the culprit [1,29]. However, the risk of developing postoperative delirium does not differ whether the patient receives a general or a regional anesthetic [36], and in fact may be greater for those receiving regional anesthesia [37], thereby shedding doubt on the putative causal role of general anesthesia [38]. Furthermore, in cardiac surgery it was noted that the risk of developing cognitive decline postoperatively did not differ depending on whether patients received on-vs. off-pump cardiac surgery [39]; therefore, the possible deleterious effects of the "pump" as a cause of "pumphead" have also been rejected as a reason for cognitive decline in cardiac surgical patients.…”