Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis

Abstract Background Postoperative delirium (POD) is widely reported as a common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to many adverse effects. We sought to investigate predictors of delirium after TJA. Methods PubMed, EMB...

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Autores principales:	Quan Zhou, Xinfeng Zhou, Yijian Zhang, Mingzhuang Hou, Xin Tian, Huilin Yang, Fan He, Xi Chen, Tao Liu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Postoperative delirium Total joint arthroplasty Total hip arthroplasty Total knee arthroplasty Predictors Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/6cfbcf2868fa45b89d6f6600c93d5e6b
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spelling	oai:doaj.org-article:6cfbcf2868fa45b89d6f6600c93d5e6b2021-11-14T12:28:37ZPredictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis10.1186/s12891-021-04825-11471-2474https://doaj.org/article/6cfbcf2868fa45b89d6f6600c93d5e6b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04825-1https://doaj.org/toc/1471-2474Abstract Background Postoperative delirium (POD) is widely reported as a common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to many adverse effects. We sought to investigate predictors of delirium after TJA. Methods PubMed, EMBASE, Cochrane Library and Web of Science were searched up to 2020 for studies examining POD following TJA in elderly patients. Pooled odds ratio (OR) and mean difference (MD) of those who experienced delirium compared to those who did not were calculated for each variable. The Newcastle-Ottawa Scale (NOS) was used for the study quality evaluation. Results Fifteen studies with 31 potential factors were included. In the primary analysis, 9 factors were associated with POD, comprising advanced age (MD 3.81; 95% confidence interval (CI) 1.80–5.83), dementia (OR 24.85; 95% CI 7.26–85.02), hypertension (OR 2.26; 95% CI 1.31–3.89), diabetes (OR 2.02; 95% CI 1.15–3.55), stroke (OR 14.61; 95% CI 5.26–40.55), psychiatric illness (OR 2.72; 95% CI 1.45–5.08), use of sedative-hypnotics (OR 6.42; 95% CI 2.53–16.27), lower preoperative levels of hemoglobin (MD − 0.56; 95% CI − 0.89−− 0.22), and lower preoperative mini-mental state examination score (MD − 0.40; 95% CI − 0.69−− 0.12). Twelve studies were included in the systematic review, of which 24 factors were additionally correlated with POD using single studies. Conclusions Strategies and interventions should be implemented for the elderly patients receiving TJA surgeries with potential predictors identified in this meta-analysis.Quan ZhouXinfeng ZhouYijian ZhangMingzhuang HouXin TianHuilin YangFan HeXi ChenTao LiuBMCarticlePostoperative deliriumTotal joint arthroplastyTotal hip arthroplastyTotal knee arthroplastyPredictorsDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Postoperative delirium Total joint arthroplasty Total hip arthroplasty Total knee arthroplasty Predictors Diseases of the musculoskeletal system RC925-935
spellingShingle	Postoperative delirium Total joint arthroplasty Total hip arthroplasty Total knee arthroplasty Predictors Diseases of the musculoskeletal system RC925-935 Quan Zhou Xinfeng Zhou Yijian Zhang Mingzhuang Hou Xin Tian Huilin Yang Fan He Xi Chen Tao Liu Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
description	Abstract Background Postoperative delirium (POD) is widely reported as a common postoperative complication following total joint arthroplasty (TJA) of the hip and knee in elderly patients, leading to many adverse effects. We sought to investigate predictors of delirium after TJA. Methods PubMed, EMBASE, Cochrane Library and Web of Science were searched up to 2020 for studies examining POD following TJA in elderly patients. Pooled odds ratio (OR) and mean difference (MD) of those who experienced delirium compared to those who did not were calculated for each variable. The Newcastle-Ottawa Scale (NOS) was used for the study quality evaluation. Results Fifteen studies with 31 potential factors were included. In the primary analysis, 9 factors were associated with POD, comprising advanced age (MD 3.81; 95% confidence interval (CI) 1.80–5.83), dementia (OR 24.85; 95% CI 7.26–85.02), hypertension (OR 2.26; 95% CI 1.31–3.89), diabetes (OR 2.02; 95% CI 1.15–3.55), stroke (OR 14.61; 95% CI 5.26–40.55), psychiatric illness (OR 2.72; 95% CI 1.45–5.08), use of sedative-hypnotics (OR 6.42; 95% CI 2.53–16.27), lower preoperative levels of hemoglobin (MD − 0.56; 95% CI − 0.89−− 0.22), and lower preoperative mini-mental state examination score (MD − 0.40; 95% CI − 0.69−− 0.12). Twelve studies were included in the systematic review, of which 24 factors were additionally correlated with POD using single studies. Conclusions Strategies and interventions should be implemented for the elderly patients receiving TJA surgeries with potential predictors identified in this meta-analysis.
format	article
author	Quan Zhou Xinfeng Zhou Yijian Zhang Mingzhuang Hou Xin Tian Huilin Yang Fan He Xi Chen Tao Liu
author_facet	Quan Zhou Xinfeng Zhou Yijian Zhang Mingzhuang Hou Xin Tian Huilin Yang Fan He Xi Chen Tao Liu
author_sort	Quan Zhou
title	Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
title_short	Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
title_full	Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
title_fullStr	Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
title_full_unstemmed	Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
title_sort	predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6cfbcf2868fa45b89d6f6600c93d5e6b
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Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis

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