Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review

Objectives Emergence delirium (ED) occurs in approximately 25% of paediatric general anaesthetics and has significant adverse effects. The goal of the current systematic review was to identify the existing literature investigating performance of predictive models for the development of paediatric ED...

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Autores principales:	Maria-Alexandra Petre, Bibek Saha, Shugo Kasuya, Marina Englesakis, Nan Gai, Arie Peliowski, Kazuyoshi Aoyama
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/ef131db2b19b4acdad1a4b165c746efa
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spelling	oai:doaj.org-article:ef131db2b19b4acdad1a4b165c746efa2021-11-12T20:00:06ZRisk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review10.1136/bmjopen-2020-0439682044-6055https://doaj.org/article/ef131db2b19b4acdad1a4b165c746efa2021-01-01T00:00:00Zhttps://bmjopen.bmj.com/content/11/1/e043968.fullhttps://doaj.org/toc/2044-6055Objectives Emergence delirium (ED) occurs in approximately 25% of paediatric general anaesthetics and has significant adverse effects. The goal of the current systematic review was to identify the existing literature investigating performance of predictive models for the development of paediatric ED following general anaesthesia and to determine their usability.Design Systematic review using the Prediction model study Risk Of Bias Assessment Tool (PROBAST) framework.Data sources Medline (Ovid), PubMed, Embase (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane CENTRAL (Ovid), PsycINFO (Ovid), Scopus (Elsevier) and Web of Science (Clarivate Analytics), ClinicalTrials.gov, International Clinical Trials Registry Platform and ProQuest Digital Dissertations and Theses International through 17 November 2020.Eligibility criteria for selecting studies All randomised controlled trials and cohort studies investigating predictive models for the development of ED in children undergoing general anaesthesia.Data extraction and synthesis Following title, abstract and full-text screening by two reviewers, data were extracted from all eligible studies, including demographic parameters, details of anaesthetics and performance characteristics of the predictive scores for ED. Evidence quality and predictive score usability were assessed according to the PROBAST framework.Results The current systematic review yielded 9242 abstracts, of which only one study detailing the development and validation of the Emergence Agitation Risk Scale (EARS) met the inclusion criteria. EARS had good discrimination with c-index of 0.81 (95% CI 0.72 to 0.89). Calibration showed a non-significant Homer-Lemeshow goodness-of-fit test (p=0.97). Although the EARS demonstrated low concern of applicability, the high risk of bias compromised the overall usability of this model.Conclusions The current systematic review concluded that EARS has good discrimination performance but low usability to predict ED in a paediatric population. Further research is warranted to develop novel models for the prediction of ED in paediatric anaesthesia.PROSPERO registration number CRD42019141950.Maria-Alexandra PetreBibek SahaShugo KasuyaMarina EnglesakisNan GaiArie PeliowskiKazuyoshi AoyamaBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 11, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Maria-Alexandra Petre Bibek Saha Shugo Kasuya Marina Englesakis Nan Gai Arie Peliowski Kazuyoshi Aoyama Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
description	Objectives Emergence delirium (ED) occurs in approximately 25% of paediatric general anaesthetics and has significant adverse effects. The goal of the current systematic review was to identify the existing literature investigating performance of predictive models for the development of paediatric ED following general anaesthesia and to determine their usability.Design Systematic review using the Prediction model study Risk Of Bias Assessment Tool (PROBAST) framework.Data sources Medline (Ovid), PubMed, Embase (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane CENTRAL (Ovid), PsycINFO (Ovid), Scopus (Elsevier) and Web of Science (Clarivate Analytics), ClinicalTrials.gov, International Clinical Trials Registry Platform and ProQuest Digital Dissertations and Theses International through 17 November 2020.Eligibility criteria for selecting studies All randomised controlled trials and cohort studies investigating predictive models for the development of ED in children undergoing general anaesthesia.Data extraction and synthesis Following title, abstract and full-text screening by two reviewers, data were extracted from all eligible studies, including demographic parameters, details of anaesthetics and performance characteristics of the predictive scores for ED. Evidence quality and predictive score usability were assessed according to the PROBAST framework.Results The current systematic review yielded 9242 abstracts, of which only one study detailing the development and validation of the Emergence Agitation Risk Scale (EARS) met the inclusion criteria. EARS had good discrimination with c-index of 0.81 (95% CI 0.72 to 0.89). Calibration showed a non-significant Homer-Lemeshow goodness-of-fit test (p=0.97). Although the EARS demonstrated low concern of applicability, the high risk of bias compromised the overall usability of this model.Conclusions The current systematic review concluded that EARS has good discrimination performance but low usability to predict ED in a paediatric population. Further research is warranted to develop novel models for the prediction of ED in paediatric anaesthesia.PROSPERO registration number CRD42019141950.
format	article
author	Maria-Alexandra Petre Bibek Saha Shugo Kasuya Marina Englesakis Nan Gai Arie Peliowski Kazuyoshi Aoyama
author_facet	Maria-Alexandra Petre Bibek Saha Shugo Kasuya Marina Englesakis Nan Gai Arie Peliowski Kazuyoshi Aoyama
author_sort	Maria-Alexandra Petre
title	Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
title_short	Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
title_full	Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
title_fullStr	Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
title_full_unstemmed	Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
title_sort	risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/ef131db2b19b4acdad1a4b165c746efa
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Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review

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