Global prevalence and predictors of postoperative delirium among non-cardiac surgical patients: A systematic review and meta-analysis

ABSTRACT Background: Postoperative delirium is a recent health problem among the elderly which is associated with delayed functional recovery, longer hospital stays, increased morbidity and mortality, and incurs a significant financial cost. Body of evidence is lacking on the global prevalence of postoperative delirium and its determinants. Therefore, this study aimed to provide evidence on the prevalence of postoperative delirium. Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 2010 to August 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting the prevalence of postoperative delirium were included. Results: A total of 930 articles were identified from different databases and 70 articles were selected for evaluation after the successive screening. Forty-three articles with 13,179 participants were included. The Meta-Analysis revealed that the global prevalence of postoperative delirium was 20% (95% confidence interval (CI):17 to 24). The systematic review showed that postoperative delirium was approximately 3 times more likely in patients undergoing surgery under general anesthesia, OR = 2.68 (95% confidence interval (CI): 1.10 to 6.54). Conclusion: The Meta-Analysis revealed that postoperative delirium among surgical patients is strongly associated with different modifiable risk factors. Therefore, the perioperative mitigating strategic protocol should be employed to prevent postoperative delirium and its undesirable outcomes. Registration: This systematic review and meta-analysis was registered research registry with the registration number (UIN: reviewregistry979). Highlights