Xiao Rong1, Zi-Chuan Ding1, Hao-da Yu1, Shun-Yu Yao1, Zong-Ke Zhou2. 1. Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, People's Republic of China. 2. Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, People's Republic of China. zhouzongke@scu.edu.cn.
Abstract
BACKGROUND: The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in knee and hip replacement. METHODS: PubMed, Ovid MEDLINE, and Ovid EMBASE were used to identify original researches. The studies evaluating the risk factors of POD after knee and hip replacement were reviewed, and the qualities of the included studies were assessed with Newcastle-Ottawa Scale. Data were extracted, pooled, and a meta-analysis was completed RESULT: Twenty-two studies were finally included with a total of 11934 patients who underwent knee or hip replacement and 1841 developed POD with an incidence of 17.6% (95% confidential interval (CI) 13.2-22.0%). Eighteen significant risk factors were identified including advanced age (odds ratio (OR) 1.15 95% CI 1.08-1.22), cognitive impairment (OR 6.84, 95% CI 3.27-14.33), history of cerebrovascular events (OR 2.51, 95% CI 1.28-4.91), knee replacement (OR 1.42, 95% CI 1.00-2.02), blood loss (standardized mean difference (SMD) 0.30, 95% CI 0.15-0.44), dementia (OR 3.09, 95% CI 2.10-4.56), neurologic disorders (OR 2.26, 95% CI 1.23-4.15), psychiatric illness (OR 2.74, 95% CI 1.34-5.62), and obstructive sleep apnea (OR 4.17, 95% CI 1.72-10.09) along with several comorbidity evaluation scores and laboratory markers. CONCLUSION: We identified risk factors consistently associated with the incidence of POD in knee and hip replacement. Strategies and interventions should be implemented to the patients receiving knee or hip replacement with potential risk factors identified in this meta-analysis.
BACKGROUND: The risk factors of postoperative delirium (POD), a serious while preventable complication, developed by patients undergoing knee and replacement surgery are still under investigation. In this systematic review and meta-analysis, we identified risk factors associated with POD in knee and hip replacement. METHODS: PubMed, Ovid MEDLINE, and Ovid EMBASE were used to identify original researches. The studies evaluating the risk factors of POD after knee and hip replacement were reviewed, and the qualities of the included studies were assessed with Newcastle-Ottawa Scale. Data were extracted, pooled, and a meta-analysis was completed RESULT: Twenty-two studies were finally included with a total of 11934 patients who underwent knee or hip replacement and 1841 developed POD with an incidence of 17.6% (95% confidential interval (CI) 13.2-22.0%). Eighteen significant risk factors were identified including advanced age (odds ratio (OR) 1.15 95% CI 1.08-1.22), cognitive impairment (OR 6.84, 95% CI 3.27-14.33), history of cerebrovascular events (OR 2.51, 95% CI 1.28-4.91), knee replacement (OR 1.42, 95% CI 1.00-2.02), blood loss (standardized mean difference (SMD) 0.30, 95% CI 0.15-0.44), dementia (OR 3.09, 95% CI 2.10-4.56), neurologic disorders (OR 2.26, 95% CI 1.23-4.15), psychiatric illness (OR 2.74, 95% CI 1.34-5.62), and obstructive sleep apnea (OR 4.17, 95% CI 1.72-10.09) along with several comorbidity evaluation scores and laboratory markers. CONCLUSION: We identified risk factors consistently associated with the incidence of POD in knee and hip replacement. Strategies and interventions should be implemented to the patients receiving knee or hip replacement with potential risk factors identified in this meta-analysis.
Entities:
Keywords:
Hip replacement; Knee replacement; Postoperative delirium; Risk factors
Authors: Nicolai Goettel; Christoph S Burkhart; Ariane Rossi; Brenno C T Cabella; Manfred Berres; Andreas U Monsch; Marek Czosnyka; Luzius A Steiner Journal: Anesth Analg Date: 2017-03 Impact factor: 5.108
Authors: Deborah J Culley; Devon Flaherty; Margaret C Fahey; James L Rudolph; Houman Javedan; Chuan-Chin Huang; John Wright; Angela M Bader; Bradley T Hyman; Deborah Blacker; Gregory Crosby Journal: Anesthesiology Date: 2017-11 Impact factor: 7.892
Authors: Stavros Memtsoudis; Crispiana Cozowicz; Nicole Zubizarreta; Sarah M Weinstein; Jiabin Liu; David H Kim; Lazaros Poultsides; Marc Moritz Berger; Madhu Mazumdar; Jashvant Poeran Journal: Reg Anesth Pain Med Date: 2019-07-12 Impact factor: 6.288
Authors: Bheeshma Ravi; Daniel Pincus; Stephen Choi; Richard Jenkinson; David N Wasserstein; Donald A Redelmeier Journal: JAMA Netw Open Date: 2019-02-01
Authors: Honoria Ocagli; Daniele Bottigliengo; Giulia Lorenzoni; Danila Azzolina; Aslihan S Acar; Silvia Sorgato; Lucia Stivanello; Mario Degan; Dario Gregori Journal: Int J Environ Res Public Health Date: 2021-07-02 Impact factor: 3.390