与老年人手术术后谵妄相关的术前预后因素：系统评价和个体患者数据荟萃分析方案。
Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis.
机构信息
Ted Rogers Center for Heart Research, University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
出版信息
Syst Rev. 2020 Nov 14;9(1):261. doi: 10.1186/s13643-020-01518-z.
BACKGROUND
Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.
METHODS
We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.
DISCUSSION
Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients.
SYSTEMATIC REVIEW REGISTRATION
CRD42020171366 .
背景
早期识别术后谵妄风险患者至关重要，因为充分的适时干预可以降低谵妄的发生和相关的不良后果。
方法
我们将对评估与择期手术老年患者术后谵妄风险增加相关的危险因素的预测价值的预后研究进行系统评价和个体患者数据（IPD）荟萃分析。我们将通过系统搜索 MEDLINE、EMBASE 和 CINAHL 从其成立到 2020 年 5 月来确定合格的研究。合格的研究将招募年龄较大的（≥50 岁）接受择期手术的成年人，并评估术前谵妄的预后危险因素和由经过培训的个体使用经过验证的谵妄评估工具测量的谵妄发生率。两名审查员将独立地、重复地筛选确定的引文的标题和摘要，审查可能合格的研究的全文。我们将联系合格研究的首席调查员，要求共享 IPD 到安全存储库。我们将使用 IPD 荟萃分析的单阶段方法，并使用 GRADE 方法评估证据的确定性。
讨论
由于我们正在使用现有的匿名数据，因此这项研究不需要伦理批准。我们的研究结果可用于指导有关预防老年患者术后谵妄的最有效方法的临床决策。
系统评价注册
CRD42020171366。
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