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Preoperative Cognitive Function As a Risk Factor of Postoperative Delirium in Cancer Surgeries: A Systematic Review and Meta-Analysis Publisher Pubmed



Varpaei HA1 ; Robbins LB1 ; Farhadi K2 ; Bender CM3
Authors
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Authors Affiliations
  1. 1. College of Nursing Michigan State University, East Lansing, MI, United States
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Nursing and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States

Source: Journal of Surgical Oncology Published:2024


Abstract

Postoperative delirium (POD) after cancer surgeries can be a result of chemo brain, anesthesia, surgery duration, and preoperative cognitive impairment. Although older age and preoperative cognitive dysfunction were reported to increase the risk of POD in noncardiac surgery, the role of preoperative cognitive function and age in the development of POD after all types of cancer surgeries is not clear. This study aimed to determine the relationship between preoperative cognitive function and likelihood of POD after cancer surgeries. This study used three main online databases and followed PRISMA guidelines. English language original articles that examined preoperative cognitive function before solid tumor cancer surgery and assessed patients for postoperative delirium were included. We employed the random effect meta-analysis method. The overall incidence of POD ranged from 8.7% to 50.9%. The confusion assessment method was the most common tool used to assess delirium. Mini-mental state evaluation (MMSE), Mini-cog, and Montreal cognitive assessment were the most common tools to assess cognitive function. The pooled (total observation = 4676) random effects SMD was estimated at −0.84 (95% confidence interval [CI]: −1.30 to −0.31), indicating that lower MMSE scores before surgery are associated with a higher risk of POD. The pooled (total observation = 2668) random effects OR was estimated at 5.17 (95% CI: 2.51 to −10.63), indicating preoperative cognitive dysfunction can significantly predict the occurrence of POD after cancer surgeries. In conclusion, preoperative cognitive function is an independent and significant predictor of POD after solid tumor cancer surgeries. © 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.
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1. Risk Factors, Time to Onset and Recurrence of Delirium in a Mixed Medical-Surgical Icu Population: A Secondary Analysis Using Cox and Chaid Decision Tree Modeling, EXCLI Journal (2022)
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