中国组织工程研究2018，Vol.22Issue(15)：2437-2445,9.DOI:10.3969/j.issn.2095-4344.0251
中国老年髋部骨折患者术后发生谵妄相关因素的Meta分析
A meta-analysis of risk factors of postoperative delirium of elderly hip fracture patients in China
摘要
Abstract
BACKGROUND: At present, there is no consensus on the risk factors for delirium after hip fracture in the elderly, and there is no risk prediction system that can effectively assess the risk of delirium after hip fracture in the elderly. OBJECTIVE: To identify the risk factors of postoperative delirium of elderly hip fracture. METHODS: Studies about delirium of elderly hip fracture patients were retrieved by computer. Quality of the studies was assessed. Analysis of sensitivity and heterogeneity was performed by RevMan 5.3 software and cumulative effects were calculated by either fixed or random effects models. RESULTS AND CONCLOUSION: (1) Totally 15 studies included 872 cases of delirium and 3 221 cases of non-delirium. (2) The results of meta-analysis showed that:univariate analysis indicated that preoperative cognitive dysfunction[pooled OR=4.99,95%CI(2.66,9.37),P=0.000],age[pooled MD=3.60,95%CI(2.21, 5.00),P=0.000],preoperative complications ≥ 3[pooled OR=2.83,95%CI(2.12,3.79),P=0.000],preoperative hemoglobin<100 mg/L[pooled OR=2.09, 95%CI(1.17,3.76),P=0.01],preoperative albumin<35 g/L[pooled OR=2.29,95%CI(1.77,2.97),P=0.01],general anesthesia[pooled OR=2.17,95%CI(1.41, 3.34),P=0.000 4],the type or treatment of hip fracture[pooled OR=1.36,95%CI(1.04,1.78),P=0.02],operation time[pooled OR=2.88,95%CI(1.42,5.82), P=0.003],and intraoperative blood loss[pooled MD=36.97,95%CI(25.74,48.19),P=0.000]were the risk factors of postoperative delirium of elderly hip fracture patients.(3)Multivariate analysis showed that preoperative cognitive dysfunction[pooled=4.94,95%CI(2.23,10.95),P=0.000],age[pooled MD=2.84,95% CI(1.89, 3.78),P=0.000],preoperative complications ≥ 3[pooled OR=3.05,95%CI(2.11,4.41),P=0.000],general anesthesia[pooled OR=4.29,95%CI(1.40,13.14), P=0.01],and operation time ≥ 2.5 hours[pooled OR=2.62,95%CI(1.68,4.08),P=0.000]were independent risk factors for postoperative delirium of elderly hip fracture patients. (4) In conclusion, the independent risk factors of postoperative delirium of elderly hip fracture patients are preoperative cognitive dysfunction, age, preoperative complications ≥ 3, general anesthesia and operation time ≥ 2.5 hours. The type of fracture, preoperative waiting time, and type of operation are not related to postoperative delirium. However, due to the low quantity and quality of the included literature, the conclusion needs the support from many high-quality studies.关键词
老年/髋部骨折/谵妄/危险因素/Meta分析分类
医药卫生引用本文复制引用
吕阳,刘启宇,刘军,陈海云,潘建科,李希文..中国老年髋部骨折患者术后发生谵妄相关因素的Meta分析[J].中国组织工程研究,2018,22(15):2437-2445,9.基金项目
广东省科技计划项目(2012B061700037) （2012B061700037）
广东省医学科学技术研究基金项目(A2017215) （A2017215）
广东省财政厅项目([2014]157号) （[2014]157号）
广东省中医院中医药科学技术研究专项资助(YK2013B2N19)the Science and Technology Project of Guangdong Province,No.2012B061700037 （YK2013B2N19）
Medical Science and Technology Research Fund of Guangdong Province,No.A2017215 （）
the Guangdong Provincial Department of Finance Foundation,No.[2014]157 （）
the Special Foundation for the Research of Science and Technology of Traditional Chinese Medicine of Guangdong Provincial Hospital of Traditional Chinese Medicine,No.YK2013B2N19 （）
