Risk Factors for Postoperative Delirium in Patients Undergoing Major Head and Neck Cancer Surgery: A Meta-analysis.
Jiaqi Sun, Ying Ji, Jingsi Huang and 1 others
PMID 38416070WHAT IT FOUND
Male sex, age older than 70 years, smoking history, psychiatric history, higher ASA score, higher preoperative albumin, postoperative insomnia, and greater intraoperative fluid intake were linked with more postoperative delirium; operative time, hemoglobin, and pain were not.
Key findings
01Significant pooled risk factors included male sex, age older than 70 years, smoking history, psychiatric disorder history, ASA score, albumin level, fluid intake, and postoperative insomnia.
02Operative time, hemoglobin level, and pain were not statistically significant pooled risk factors.
03The included studies reported a total of 4188 patients and 647 delirium cases.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies varied by country, disease site, and delirium assessment tool, so the pooled estimates may not apply to every patient. Heterogeneity was high for age older than 70 years, operative time, hemoglobin level, and pain, so the pooled estimates for these factors were less consistent. Only English-language studies were included, so studies from regions with high head and neck cancer prevalence may be missing. The authors noted small sample sizes in included studies, which made true risk estimates difficult. Hazard ratios were not pooled because too few studies reported them. The authors state the etiology of postoperative delirium remains unclear and common prevention strategies do not exist.
Declared interests
The authors reported no funding or conflicts of interest.
The easy way to misread this
Do not conclude that changing these factors will prevent postoperative delirium. The authors state the etiology remains unclear and common strategies to prevent it do not exist.