Postoperative delirium in patients undergoing cardiac surgery was associated with significantly higher mortality (OR 2.77; 95% CI 1.86-4.11; P<0.001) compared to patients without delirium.
Meta-Analysis (n=19,785)
Does postoperative delirium increase mortality and prolong hospital stay in patients undergoing cardiac surgery?
Postoperative delirium in cardiac surgery patients is significantly associated with increased mortality, prolonged mechanical ventilation, and longer ICU and hospital stays.
Effect estimate: OR 2.77 (95% CI 1.86-4.11)
p-value: p=<0.001
Background Postoperative delirium (POD) is an acute brain dysfunction that is frequently observed in patients undergoing cardiac surgery. Increasing evidence indicates POD is related to higher mortality among cardiac surgical patients, but the results remain controversial. Moreover, a quantitative evaluation of the influence of POD on hospital days, intensive care unit (ICU) time, and mechanical ventilation (MV) time has not been performed. Objective This study aimed to evaluate the correlation between POD and outcomes in patients undergoing cardiac surgery by a systematic review and meta-analysis. Materials and methods A total of 7 electronic databases (Cochrane Library, PubMed, EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National Knowledge Infrastructure) were searched from January 1980 to July 20, 2021, with language restrictions to English and Chinese, to estimate the impact of the POD on outcome in patients who underwent cardiac surgery. The meta-analysis was registered with PROSPERO (Registration: CRD42021228767). Results Forty-two eligible studies with 19785 patients were identified. 3368 (17.0%) patients were in the delirium group and 16417 (83%) were in the non-delirium group. The meta-analysis showed that compared to patients without POD, patients with POD had 2.77-fold higher mortality (OR = 2.77, 95% CI 1.86–4.11, P 0.001), 5.70-fold higher MV (24h) rate (OR = 5.70, 95% CI 2.93–11.09, P 0.001); and longer MV time (SMD = 0.83, 95% CI 0.57–1.09, P 0.001), ICU time (SMD = 0.91, 95% CI 0.60–1.22, P 0.001), hospital days (SMD = 0.62, 95% CI 0.48–0.76, P 0.001). Conclusion The synthesized evidence suggests that POD is causally related to the increased risk of mortality, prolonged length of ICU and hospital stay, and a longer duration of MV time. Future research should focus on the interventions for POD, to reduce the incidence. Systematic review registration www.crd.york.ac.uk/PROSPERO , identifier CRD42021228767.
Lin et al. (Tue,) conducted a meta-analysis in Postoperative delirium in patients undergoing cardiac surgery (n=19,785). Postoperative delirium vs. No postoperative delirium was evaluated on Mortality (OR 2.77, 95% CI 1.86-4.11, p=<0.001). Postoperative delirium in patients undergoing cardiac surgery was associated with significantly higher mortality (OR 2.77; 95% CI 1.86-4.11; P<0.001) compared to patients without delirium.