Prevalence and risk factors of postoperative delirium after spinal surgery: a meta-analysis
Prevalence and risk factors of postoperative delirium after spinal surgery: a meta-analysis
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DOI：
10.1186/s13018-020-01651-4
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发表时间：
2020-04-09
影响因子：
2.6
通讯作者：
Li, Zheng
中科院分区：
文献类型：
--
作者：
Gao, Hua;Ma, Hui-Juan;Li, Zheng
目的脊柱手术后谵妄（POD）是一种常见的并发症，但以往研究的主要结果仍不一致。本荟萃分析旨在探讨脊柱手术后POD的患病率和危险因素。方法检索PubMed和Embase，检索时间从开始到2019年6月。纳入了报告脊柱手术后POD患病率和危险因素的研究。采用STATA 12.0版对合并数据进行分析。使用I-2统计量确定纳入研究的统计异质性。结果共纳入28篇文献，纳入患者588,732例。脊柱手术后POD的合并患病率为0.85%（95%CI，0.83-0.88%），具有显著异质性（I-2 = 97.3%）。中枢神经系统疾病（OR 4.73; 95%CI，4.30-5.19）是POD的强预测因子，而年龄（OR 1.16; 95%CI，1.05-2.47; I-2 = 99.2%）和失血量（OR 1.10; 95%CI，1.01-1.20; I-2 = 93.3%）是较弱的预测因子。漏斗图和统计学检验提示存在潜在的发表偏倚，但修剪填充法表明增加两个“缺失”研究后，合并患病率基本保持稳定。结论脊柱手术后合并POD范围为0.83 - 0.88%。中枢神经系统疾病、年龄、失血量是POD的潜在危险因素。
Objective Postoperative delirium (POD) was common after spinal surgery, but the main findings in previous studies remained conflicting. This current meta-analysis was aimed at exploring the prevalence and risk factors of POD after spinal surgery. Methods PubMed and Embase were searched from inception to June 2019. Studies which reported the prevalence and risk factors of POD after spinal surgery were included. STATA version 12.0 was employed to analyze the pooled data. Statistical heterogeneity across included studies was identified using the I-2 statistics. Results A total of 28 studies with 588,732 patients were included in the meta-analysis. The pooled prevalence of POD after spinal surgery was 0.85% (95%CI, 0.83-0.88%) with substantial heterogeneity (I-2 = 97.3%). The central nervous system disorder (OR 4.73; 95%CI, 4.30-5.19) was a strong predictor for POD, whereas age (OR 1.16; 95%CI, 1.05-2.47; I-2 = 99.2%) and blood loss (OR 1.10; 95%CI, 1.01-1.20; I-2 = 93.3%) were weaker predictors. The funnel plot and statistical tests suggested that there existed potential publication bias, but the trim and fill method indicated that the pooled prevalence basically kept stable after adding two "missing" studies. Conclusions The pooled POD after spinal surgery ranges from 0.83 to 0.88%. The central nervous system disorder, age, and blood loss were potential risk factors for POD.