School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR.
Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan.
Otolaryngol Head Neck Surg. 2024 Feb;170(2):335-346. doi: 10.1002/ohn.557. Epub 2023 Oct 11.
To summarize the incidence of postoperative delirium among cancer patients undergoing head and neck surgery and determine the differential incidence rates among patients undergoing different types of head and neck surgeries.
The databases of PubMed, Cochrane Library, Web of Science, EMBASE, and CINAHL were searched from inception till February 2023. Keywords based on the condition (delirium), context (postoperative), and population (head and neck cancer) were used as search terms.
The PRISMA and MOOSE reporting guidelines were followed. The Joanna Briggs Institute critical appraisal checklists for cohort studies, case-control studies, and randomized controlled trials were used to evaluate the methodological quality. Data were pooled using a random-effects model, and the incidence with 95% confidence intervals was evaluated using the exact binomial method and Freeman-Tukey double arcsine transformation of proportions. I was used to indicate heterogeneity. Predefined subgroup analysis and Meta-regression, was performed to identify the factors affecting heterogeneity.
The summary incidence of postoperative delirium was 18.95% [95% confidence interval, 14.36%-24.00%] with between-study heterogeneity (I = 95.46%). The incidence of postoperative delirium in patients who underwent free flap reconstruction was 22.13%, which was higher than those of other types of surgeries. Meta-regression revealed that conducted in sample size (P = .007) of the included studies was the factors affecting heterogeneity.
The evidence on postoperative delirium incidence provided by the current Meta-analysis enables effective treatment planning.
总结头颈部手术癌症患者术后谵妄的发生率，并确定不同类型头颈部手术患者的差异发生率。
从建库到 2023 年 2 月，检索了 PubMed、Cochrane Library、Web of Science、EMBASE 和 CINAHL 数据库。使用基于疾病（谵妄）、环境（术后）和人群（头颈部癌症）的关键词作为搜索词。
遵循 PRISMA 和 MOOSE 报告指南。使用 Joanna Briggs 研究所的队列研究、病例对照研究和随机对照试验的批判性评价清单来评估方法学质量。使用随机效应模型汇总数据，并使用精确二项式法和 Freeman-Tukey 双反正弦变换比例评估发生率和 95%置信区间。I 用于表示异质性。进行了预先定义的亚组分析和 Meta 回归，以确定影响异质性的因素。
术后谵妄的总发生率为 18.95%（95%置信区间，14.36%-24.00%），存在研究间异质性（I = 95.46%）。游离皮瓣重建患者术后谵妄发生率为 22.13%，高于其他类型手术。Meta 回归显示，纳入研究的样本量（P = .007）是影响异质性的因素。
本 Meta 分析提供的术后谵妄发生率证据可用于有效的治疗计划。
