Suzuki Rio, Nakanishi Aina, Masuya Masahiro, Fukuroku Keiko, Taneda Yukari, Matsuura Yutaka
Mie University Hospital, Tsu, Mie, Japan.
Kariya Toyota general hospital, Kariya, Aichi, Japan.
PLoS One. 2025 Apr 1;20(4):e0321025. doi: 10.1371/journal.pone.0321025. eCollection 2025.
Delirium is a common complication in surgical patients following operative procedures; it often occurs in patients undergoing lower-extremity surgery. It is essential to identify and prevent the risk factors for postoperative delirium (POD) in these cases. We aimed to determine the risk factors for POD in patients who underwent lower-extremity surgery through a systematic review and meta-analysis. We included observational studies identifying risk factors for POD in patients undergoing orthopedic surgery. Data sources included the Cumulative Index to Nursing and Allied Health Literature and MEDLINE. We extracted the variables related to delirium that were analyzed by two or more studies meeting the eligibility criteria. A random-effects model was used to calculate the pooled odds ratio, standardized mean difference, and 95% confidence interval. Data were considered significant when p < 0.05. Twenty-seven studies with a total sample size of 9,044 were evaluated. Our meta-analysis revealed 20 risk factors for patients with POD undergoing orthopedic surgery, including age, cognitive scores, various preoperative laboratory values (such as serum albumin, C-reactive protein, and thyroid hormones), length of hospital stay, surgery and anesthesia duration, blood transfusion, and previous health conditions such as dementia and cardiovascular disease. Gathering preoperative and postoperative data was crucial for identifying high-risk patients for POD. In addition, preventive measures targeting POD risk factors could reduce its occurrence after orthopedic surgery.
谵妄是外科手术患者术后常见的并发症；它常发生在接受下肢手术的患者中。在这些病例中，识别并预防术后谵妄（POD）的危险因素至关重要。我们旨在通过系统评价和荟萃分析确定接受下肢手术患者发生POD的危险因素。我们纳入了确定骨科手术患者POD危险因素的观察性研究。数据来源包括护理及相关健康文献累积索引和医学期刊数据库。我们提取了两项或更多符合纳入标准的研究分析的与谵妄相关的变量。采用随机效应模型计算合并比值比、标准化均数差和95%置信区间。当p < 0.05时，数据被认为具有统计学意义。共评估了27项研究，总样本量为9044例。我们的荟萃分析揭示了接受骨科手术的POD患者的20个危险因素，包括年龄、认知评分、各种术前实验室值（如血清白蛋白、C反应蛋白和甲状腺激素）、住院时间、手术和麻醉持续时间、输血以及既往健康状况如痴呆和心血管疾病。收集术前和术后数据对于识别POD高危患者至关重要。此外，针对POD危险因素的预防措施可以减少骨科手术后POD的发生。
