A systematic review of influencing factors of postoperative delirium in patients with liver surgery
10.3760/cma.j.cn115682-20220121-00354
- VernacularTitle:肝脏手术患者术后谵妄影响因素的系统评价
- Author:
Qingyue CHEN
1
;
Yan WANG
;
Mengting YU
;
Meihua WU
;
Xiumei CHEN
Author Information
1. 福建医科大学肿瘤临床医学院 福建省肿瘤医院肝胆胰肿瘤外科，福州 350014
- Keywords:
Digestive system diseases;
Liver;
Delirium;
Risk factors;
Meta-analysis
- From:
Chinese Journal of Modern Nursing
2022;28(29):3998-4005
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically review the risk factors of postoperative delirium in patients with liver surgery, in order to provide reference for early clinical prevention of postoperative delirium in patients with liver surgery.Methods:PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI) , Wanfang Database, VIP and China Biomedical Literature Database were searched by computer from the establishment of the database to July 31, 2021. Two researchers conducted literature screening, quality evaluation and data extraction. RevMan 5.4 was used for data analysis.Results:Finally, 15 articles were included. Meta-analysis results showed that advanced age ( OR=1.13, 95% CI: 1.06-1.22, Z=3.49, P=0.0005) , history of cerebrovascular disease ( OR=3.27, 95% CI: 1.89-5.66, Z=4.24, P<0.000 1) , history of hepatic encephalopathy ( OR=2.49, 95% CI: 1.70-3.65, Z=4.68, P<0.000 01) , history of mental illness ( OR=2.82, 95% CI: 1.52-5.22, Z=3.30, P=0.001) , history of sedative-hypnotic use ( OR=4.12, 95% CI: 1.99-8.52, Z=3.82, P=0.000 1) , history of drinking ( OR=1.96, 95% CI: 1.18-3.26, Z=2.61, P=0.009) , postoperative infection ( OR=5.76, 95% CI: 4.24-7.84, Z=11.18, P<0.000 01) were independent risk factors for postoperative delirium in patients with liver surgery. Increased preoperative albumin level ( OR=3.31, 95% CI: 0.19-0.52, Z=4.52, P<0.000 01) was a protective factor for postoperative delirium in patients undergoing liver surgery. There were no statistically significant differences in effects of end-stage liver disease model score, preoperative serum total bilirubin level, postoperative increased serum sodium level, postoperative ICU admission, acute physiology and chronic health scores on postoperative delirium in patients with liver surgery ( P>0.05) . Conclusions:Advanced age, history of cerebrovascular disease, history of mental illness, history of hepatic encephalopathy, history of sedative-hypnotic use, history of alcohol consumption and postoperative infection are independent risk factors for postoperative delirium in patients with liver surgery, and elevated preoperative albumin level is associated with postoperative delirium. protective factor.
