Incidence of postoperative delirium in older adults undergoing surgical procedures: A systematic literature review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies
PubMed 37128953 · doi:10.1111/wvn.12649
What was done
Authors conducted a systematic review and meta-analysis across PubMed, Cochrane Library, Embase, and CINAHL up to October 2020 to determine the incidence of postoperative delirium (POD) by surgery type in adults aged 65 years and older. From 28 retrieved meta-analyses comprising 284 studies, data from 90 relevant individual studies were extracted and categorized across eight surgery types.
What was found
POD incidence varied across surgical categories: cardiac (32%), abdominal (30%), mixed (26%), orthopedic (20%), vascular (14%), colorectal (14%), spinal (13%), and urologic (10%). Delirium detection instruments differed across included studies, with the Confusion Assessment Method (CAM and CAM-ICU) being the most commonly utilized tool.
Why it matters
This review provides surgery-specific baseline risks of delirium in older adults, demonstrating that higher-complexity procedures like cardiac and abdominal operations carry roughly triple the risk of urologic operations.
Limits
The search window ended in October 2020. The abstract reports point estimates without confidence intervals, total patient counts, or heterogeneity metrics. Delirium assessment tools varied across the primary studies, introducing potential diagnostic inconsistency.
Cited by
- partial Postoperative delirium incidence can reach up to 40% in elderly patients aged 65 and older, and up to 70% in open-heart or major surgeries.