Incidence of postoperative delirium in older adults undergoing surgical procedures: A systematic literature review and meta-analysis

被引：33

作者：

Igwe, Ezinne Oyidia ^{[1
,2
]}

Nealon, Jessica ^{[2
,3
]}

O'Shaughnessy, Pauline ^{[4
]}

Bowden, Alera ^{[1
,2
,5
]}

Chang, Hui-Chen ^{[1
,2
,6
]}

Ho, Mu-Hsing ^{[7
]}

Montayre, Jed ^{[8
]}

Montgomery, Amy ^{[1
,2
]}

Rolls, Kaye ^{[1
]}

Chou, Kuei-Ru ^{[9
,10
,11
,12
]}

Chen, Kee-Hsin ^{[10
,13
,14
,15
]}

Traynor, Victoria ^{[1
,2
]}

Smerdely, Peter ^{[16
,17
]}

机构：

[1] Univ Wollongong, Fac Sci Med & Hlth, Sch Nursing, Wollongong, NSW, Australia

[2] Illawarra Hlth & Med Res Inst IHMRI, Wollongong, NSW, Australia

[3] Univ Wollongong, Fac Sci Med & Hlth, Sch Med, Wollongong, NSW, Australia

[4] Univ Wollongong, Fac Engn & Informat Sci, Sch Math & Appl Stat, Wollongong, NSW, Australia

[5] Illawarra Shoalhaven Local Hlth Dist, Wollongong, NSW, Australia

[6] Western Sydney Univ, Sch Nursing & Midwifery, Penrith, NSW, Australia

[7] Univ Hong Kong, LKS Fac Med, Sch Nursing, Pok Fu Lam, Hong Kong, Peoples R China

[8] Hong Kong Polytech Univ, Sch Nursing, Hung Hom, Hong Kong, Peoples R China

[9] Taipei Med Univ, Coll Nursing, Sch Nursing, Taipei, Taiwan

[10] Taipei Med Univ, Wan Fang Hosp, Ctr Nursing & Healthcare Res Clin Practice Applica, Taipei, Taiwan

[11] Taipei Med Univ, Shuang Ho Hosp, Dept Nursing, New Taipei, Taiwan

[12] Taipei Med Univ Hosp, Psychiat Res Ctr, Taipei, Taiwan

[13] Taipei Med Univ, Coll Nursing, Postbaccalaureate Program Nursing, Taipei, Taiwan

[14] Taipei Med Univ, Cochrane Taiwan, Taipei, Taiwan

[15] Taipei Med Univ, Wan Fang Hosp, Evidence based Knowledge Translat Ctr, Taipei, Taiwan

[16] UNSW Med, Sch Populat Hlth, Sydney, NSW, Australia

[17] St George Hosp, Kogarah, NSW, Australia

来源：

WORLDVIEWS ON EVIDENCE-BASED NURSING | 2023年 / 20卷 / 03期

关键词：

incidence; meta-analysis; older people; postoperative delirium; systematic review; ACUTE CONFUSIONAL STATES; HIP FRACTURE REPAIR; ELDERLY-PATIENTS; RISK-FACTORS; SPINE SURGERY; COGNITIVE DYSFUNCTION; CARDIAC-SURGERY; INDEPENDENT PREDICTOR; GERIATRIC ASSESSMENT; DEPRESSIVE SYMPTOMS;

D O I：

10.1111/wvn.12649

中图分类号：

R47 [护理学];

学科分类号：

1011 ;

摘要：

BackgroundWith the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (>= 65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over. MethodsDatabases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed. ResultsA total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted. Linking Evidence to ActionThis study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.

引用

页码：220 / 237

页数：18

共 140 条

[21] Impaired Mobility, ASA Status and Administration of Tramadol are Risk Factors for Postoperative Delirium in Patients Aged 75 Years or More After Major Abdominal Surgery [J].