Kusirisin Prit, Kung Janice Y, Corsaro Angela, Rewa Oleksa, Wilcox M Elizabeth, Bagshaw Sean M
Faculty of Medicine and Dentistry, Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand.
BMJ Open. 2025 Aug 27;15(8):e105515. doi: 10.1136/bmjopen-2025-105515.
Acute kidney injury (AKI) and delirium are common clinical complications of critical illness. Relatively few studies have evaluated the relationship between AKI and delirium. This systematic review will assess this association among critically ill patients.
We will conduct comprehensive searches of databases, including Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, Web of Science Core Collection and the Cochrane Library, using keywords to capture the existing literature related to AKI and delirium. Searches will range from inception to January 2025. Two reviewers will independently screen, select and extract studies using the web-based tool, Covidence. Inclusion criteria will include clinical trials or observational cohorts reporting both AKI and delirium in patients admitted to intensive care units. Case reports, case series and preclinical or experimental studies will be excluded. The quality and risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk-of-Bias tool for randomised controlled trials. The primary outcome will be the proportion of critically ill patients with AKI who develop delirium. Secondary outcomes will include the proportion of patients with delirium stratified by AKI severity or receipt of renal replacement therapy as well as clinical factors associated with delirium, mortality and health service outcomes, including organ support use and lengths of stay.
Ethics approval is not required for this study, as all data included in this evaluation are already published, and our study will not directly involve human participants. Findings will be disseminated through academic conferences and published in a peer-reviewed journal.
CRD420251001864.
急性肾损伤（AKI）和谵妄是危重症常见的临床并发症。相对较少的研究评估了AKI与谵妄之间的关系。本系统评价将评估危重症患者中的这种关联。
我们将对多个数据库进行全面检索，包括Ovid MEDLINE、Ovid Embase、CINAHL、Scopus、Web of Science核心合集和Cochrane图书馆，使用关键词来获取与AKI和谵妄相关的现有文献。检索时间范围从数据库创建至2025年1月。两名评价者将使用基于网络的工具Covidence独立筛选、选择和提取研究。纳入标准将包括报告重症监护病房患者同时发生AKI和谵妄的临床试验或观察性队列研究。病例报告、病例系列以及临床前或实验性研究将被排除。将使用纽卡斯尔-渥太华量表评估观察性研究的质量和偏倚风险，使用Cochrane偏倚风险工具评估随机对照试验的质量和偏倚风险。主要结局将是发生AKI的危重症患者发生谵妄的比例。次要结局将包括按AKI严重程度或接受肾脏替代治疗分层的谵妄患者比例，以及与谵妄、死亡率和卫生服务结局相关的临床因素，包括器官支持的使用和住院时间。
本研究无需伦理批准，因为本评价中纳入的所有数据均已发表，且我们的研究不会直接涉及人类参与者。研究结果将通过学术会议进行传播，并发表在同行评审期刊上。
PROSPERO注册号：CRD420251001864。
