Prevalence and Risk Factors for Postoperative Delirium in Patients with Colorectal Carcinoma: a Systematic Review and Meta-analysis

Overview

Journal Int J Colorectal Dis

Specialties Gastroenterology
General Surgery

Date 2020 Jan 20

PMID 31955218

Citations 12

Authors

Zheng Yang

Xiao-Feng Wang

Long-Fei Yang

Chen Fang

Xiao-Ke Gu

Hui-Wen Guo

Affiliations

Soon will be listed here.

Abstract

Objective: Postoperative delirium (POD) is a common, but severe complication in elderly patients undergoing surgery for colorectal cancer, but the prevalence and potential risk factors for POD were not well established. Therefore, a meta-analysis was preformed to clarify the prevalence and risk factors of POD in patients undergoing surgery for colorectal cancer.

Methods: PubMed, Embase, and the Cochrane Library were systematically searched on August 2019. Studies were included if they reported the prevalence and risk factors of POD in patients undergoing colorectal cancer surgery. The guidelines for critically appraising studies of prevalence or incidence of a health problem were used to assess the quality of included studies. Pooled odds ratios (ORs) for individual risk factors were estimated using the Mantel-Haenszel methods in random effect model. Sensitive analyses based on different inclusion criteria were conducted to explore whether the current meta-analysis was enough credible and robust.

Results: Seventeen studies totaling 4472 patients undergoing colorectal cancer surgery were included. The pooled prevalence of POD is 14% (95% CI = 12-17%). Twelve significant risk factors were identified in pooled analysis including older age (OR = 1.10), sex (OR = 1.87), history of psychiatric disease (OR = 6.47), comorbidities (OR = 2.17), prognostic nutritional index (OR = 1.12), physical status (OR = 1.27), American Society of Anesthesiologists Score (ASA Scores) (OR = 1.65), history of alcohol abuse (OR = 2.23), postoperative pain management (OR = 1.91), perioperative blood transfusion (OR = 2.37), cognitive status (OR = 1.91), and lower serum level of albumin (OR = 0.58).

Conclusions: POD is a frequent complication in patients undergoing surgery with colorectal cancer. Several risk factors including history of psychiatric disease, transfusion, comorbidities, male gender, and old age were significant predictors for POD.

Citing Articles

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Overtime work of anesthesiologists is associated with increased delirium in older patients admitted to intensive care unit after noncardiac surgery: a secondary analysis.

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Sadeghirad B, Dodsworth B, Gelsomino N, Goettel N, Spence J, Buchan T JAMA Netw Open. 2023; 6(10):e2337239.

PMID: 37819663 PMC: 10568362. DOI: 10.1001/jamanetworkopen.2023.37239.

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