Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis
Abstract Background The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-020-02127-1 |
| _version_ | 1828179804985229312 |
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| author | Xiao Rong Zi-chuan Ding Hao-da Yu Shun-Yu Yao Zong-Ke Zhou |
| author_facet | Xiao Rong Zi-chuan Ding Hao-da Yu Shun-Yu Yao Zong-Ke Zhou |
| author_sort | Xiao Rong |
| collection | DOAJ |
| description | Abstract Background The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in knee and hip replacement. Methods PubMed, Ovid MEDLINE, and Ovid EMBASE were used to identify original researches. The studies evaluating the risk factors of POD after knee and hip replacement were reviewed, and the qualities of the included studies were assessed with Newcastle–Ottawa Scale. Data were extracted, pooled, and a meta-analysis was completed Result Twenty-two studies were finally included with a total of 11934 patients who underwent knee or hip replacement and 1841 developed POD with an incidence of 17.6% (95% confidential interval (CI) 13.2–22.0%). Eighteen significant risk factors were identified including advanced age (odds ratio (OR) 1.15 95% CI 1.08–1.22), cognitive impairment (OR 6.84, 95% CI 3.27–14.33), history of cerebrovascular events (OR 2.51, 95% CI 1.28–4.91), knee replacement (OR 1.42, 95% CI 1.00–2.02), blood loss (standardized mean difference (SMD) 0.30, 95% CI 0.15–0.44), dementia (OR 3.09, 95% CI 2.10–4.56), neurologic disorders (OR 2.26, 95% CI 1.23–4.15), psychiatric illness (OR 2.74, 95% CI 1.34–5.62), and obstructive sleep apnea (OR 4.17, 95% CI 1.72–10.09) along with several comorbidity evaluation scores and laboratory markers. Conclusion We identified risk factors consistently associated with the incidence of POD in knee and hip replacement. Strategies and interventions should be implemented to the patients receiving knee or hip replacement with potential risk factors identified in this meta-analysis. |
| first_indexed | 2024-04-12T05:34:35Z |
| format | Article |
| id | doaj.art-7aa69c56723044a496abdd0c3e26c986 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-12T05:34:35Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-7aa69c56723044a496abdd0c3e26c9862022-12-22T03:45:54ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-01-0116111810.1186/s13018-020-02127-1Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysisXiao Rong0Zi-chuan Ding1Hao-da Yu2Shun-Yu Yao3Zong-Ke Zhou4Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityAbstract Background The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in knee and hip replacement. Methods PubMed, Ovid MEDLINE, and Ovid EMBASE were used to identify original researches. The studies evaluating the risk factors of POD after knee and hip replacement were reviewed, and the qualities of the included studies were assessed with Newcastle–Ottawa Scale. Data were extracted, pooled, and a meta-analysis was completed Result Twenty-two studies were finally included with a total of 11934 patients who underwent knee or hip replacement and 1841 developed POD with an incidence of 17.6% (95% confidential interval (CI) 13.2–22.0%). Eighteen significant risk factors were identified including advanced age (odds ratio (OR) 1.15 95% CI 1.08–1.22), cognitive impairment (OR 6.84, 95% CI 3.27–14.33), history of cerebrovascular events (OR 2.51, 95% CI 1.28–4.91), knee replacement (OR 1.42, 95% CI 1.00–2.02), blood loss (standardized mean difference (SMD) 0.30, 95% CI 0.15–0.44), dementia (OR 3.09, 95% CI 2.10–4.56), neurologic disorders (OR 2.26, 95% CI 1.23–4.15), psychiatric illness (OR 2.74, 95% CI 1.34–5.62), and obstructive sleep apnea (OR 4.17, 95% CI 1.72–10.09) along with several comorbidity evaluation scores and laboratory markers. Conclusion We identified risk factors consistently associated with the incidence of POD in knee and hip replacement. Strategies and interventions should be implemented to the patients receiving knee or hip replacement with potential risk factors identified in this meta-analysis.https://doi.org/10.1186/s13018-020-02127-1Knee replacementHip replacementPostoperative deliriumRisk factors |
| spellingShingle | Xiao Rong Zi-chuan Ding Hao-da Yu Shun-Yu Yao Zong-Ke Zhou Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Knee replacement Hip replacement Postoperative delirium Risk factors |
| title | Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis |
| title_full | Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis |
| title_fullStr | Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis |
| title_full_unstemmed | Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis |
| title_short | Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis |
| title_sort | risk factors of postoperative delirium in the knee and hip replacement patients a systematic review and meta analysis |
| topic | Knee replacement Hip replacement Postoperative delirium Risk factors |
| url | https://doi.org/10.1186/s13018-020-02127-1 |
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