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Meta-Analysis
. 2022 Feb;45(1):329-341.
doi: 10.1007/s10143-021-01619-w. Epub 2021 Aug 16.

Delirium in neurosurgery: a systematic review and meta-analysis

P R Kappen  1 , E Kakar  2   3 , C M F Dirven  4 , M van der Jagt  3 , M Klimek  5 , R J Osse  6 , A P J E Vincent  4
Affiliations
Meta-Analysis

Delirium in neurosurgery: a systematic review and meta-analysis

P R Kappen et al. Neurosurg Rev. 2022 Feb.

Abstract

Delirium is a frequent occurring complication in surgical patients. Nevertheless, a scientific work-up of the clinical relevance of delirium after intracranial surgery is lacking. We conducted a systematic review (CRD42020166656) to evaluate the current diagnostic work-up, incidence, risk factors and health outcomes of delirium in this population. Five databases (Embase, Medline, Web of Science, PsycINFO, Cochrane Central) were searched from inception through March 31st, 2021. Twenty-four studies (5589 patients) were included for qualitative analysis and twenty-one studies for quantitative analysis (5083 patients). Validated delirium screening tools were used in 70% of the studies, consisting of the Confusion Assessment Method (intensive care unit) (45%), Delirium Observation Screening Scale (5%), Intensive Care Delirium Screening Checklist (10%), Neelon and Champagne Confusion Scale (5%) and Nursing Delirium Screening Scale (5%). Incidence of post-operative delirium after intracranial surgery was 19%, ranging from 12 to 26% caused by variation in clinical features and delirium assessment methods. Meta-regression for age and gender did not show a correlation with delirium. We present an overview of risk factors and health outcomes associated with the onset of delirium. Our review highlights the need of future research on delirium in neurosurgery, which should focus on optimizing diagnosis and assessing prognostic significance and management.

Keywords: Delirium; Incidence rates; Neurosurgery; Screening tools.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Pooled incidence delirium in neurosurgery
Fig. 2
Fig. 2
Funnel plot pooled incidence delirium in neurosurgery
Fig. 3
Fig. 3
Subgroup analysis validated vs non-validated screening tools
Fig. 4
Fig. 4
Meta-regression: age and incidence delirium
Fig. 5
Fig. 5
Meta-regression: gender and incidence delirium
See this image and copyright information in PMC

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