Systematic literature review on early detection of postoperative delirium in adult patients after cardiac surgery.

BACKGROUND

Postoperative delirium (POD) is a cognitive decline and attention deficit that can occur in patients after cardiac surgery. Despite extensive research identifying the risk factors, POD often remains undiagnosed and untreated in medical settings. Therefore, this systematic literature review (SLR) aimed to summarize the available studies on early POD identification in patients following cardiovascular surgery.

METHOD

Data were obtained from Scopus, PubMed, and the Cochrane International database. The search strategy was designed to identify articles published between January 2000 and January 2024. The keywords and medical subject heading (MeSH) terms used in the search included "postoperative delirium," "cardiac surgery," "early detection," and "risk factors." Studies were included if they met the following criteria: (1) focused on adult patients undergoing cardiac surgery; (2) examined methods for the early identification or prediction of POD; and (3) provided statistical analyses or clinical outcomes related to POD. The exclusion criteria were: studies on non-cardiac surgeries, pediatric populations, or those without clear methodological details.

RESULTS

Seven of the examined studies highlighted high-risk variables (individual characteristics, underlying diseases, and treatment methods) and typical symptoms as crucial components for early POD diagnosis. However, the diagnostic criteria and evaluation methodologies needed to be more consistent, and there was no consensus regarding the most efficient early detection approaches.

CONCLUSION

These findings underscore the need for standardized diagnostic criteria and evaluation methods for the early detection of POD in patients undergoing cardiovascular surgery. Evidence-based recommendations are necessary to enhance early diagnosis and treatment of POD in this population.