TY - JOUR
T1 - Incidence of postoperative delirium in older adults undergoing surgical procedures
T2 - A systematic literature review and meta-analysis
AU - Igwe, Ezinne Oyidia
AU - Nealon, Jessica
AU - O'Shaughnessy, Pauline
AU - Bowden, Alera
AU - Chang, Hui Chen
AU - Ho, Mu Hsing
AU - Montayre, Jed
AU - Montgomery, Amy
AU - Rolls, Kaye
AU - Chou, Kuei Ru
AU - Chen, Kee Hsin
AU - Traynor, Victoria
AU - Smerdely, Peter
N1 - Publisher Copyright:
© 2023 The Authors. Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International.
PY - 2023/6
Y1 - 2023/6
N2 - Background: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over. Methods: Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed. Results: A total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted. Linking Evidence to Action: This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.
AB - Background: With the increase in life expectancy around the globe, the incidence of postoperative delirium (POD) among older people (≥65 years) is growing. Previous studies showed a wide variation in the incidence of POD, from 4% to 53%, with a lack of specific evidence about the incidence of POD by specific surgery type among older people. The aim of this systematic review and meta-analysis was to determine the incidence of POD by surgery type within populations 65 years and over. Methods: Databases including PubMed, Cochrane library, Embase, and CINAHL were searched until October 2020. Due to the relatively higher number of meta-analyses undertaken in this area of research, a streamlined systematic meta-analysis was proposed. Results: A total of 28 meta-analyses (comprising 284 individual studies) were reviewed. Data from relevant individual studies (n = 90) were extracted and included in the current study. Studies were grouped into eight surgery types and the incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal, abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%, 10%, and 26%, respectively. POD detection instruments were different across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being the most frequently adopted. Linking Evidence to Action: This study showed that POD incidence in older people undergoing surgery varied widely across surgery type. The more complex surgeries like cardiac and abdominal surgeries were associated with a higher risk of POD. This highlights the need to include the level of surgery complexity as a risk factor in preoperative assessments.
KW - incidence
KW - meta-analysis
KW - older people
KW - postoperative delirium
KW - systematic review
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U2 - 10.1111/wvn.12649
DO - 10.1111/wvn.12649
M3 - Article
C2 - 37128953
AN - SCOPUS:85157988070
SN - 1545-102X
VL - 20
SP - 220
EP - 237
JO - Worldviews on Evidence-Based Nursing
JF - Worldviews on Evidence-Based Nursing
IS - 3
ER -