Objective To explore the influencing factors of postoperative delirium in patients with liver transplantation by using Meta analysis method,to provide evidence-based evidence for better prevention and management of postoperative delirium in patients with liver transplantation.Methods Computer searches databases such as PubMed,Embase,Cochrane Library,Web of science,Sinomed,CNKI,and Wanfang,and searches published case-control studies and cohort studies on postoperative delirium in patients with liver transplantation.The search time limit is from the establishment of the database to December 2022.The literature is screened,the quality of the literature is evaluated,and the data is extracted.Meta analysis is performed using Stata16.0 software.Results A total of 12 literatures were included,including 5 case-control studies and 7 cohort studies.According to the Newcastle-Ottawa Scale(NOS)score,all were high-quality literature,and a total of 3078 patients with liver transplantation were included,with a postoperative delirium complication rate of about 20%.Meta analysis showed age[SMD=0.155,95%CI(0.026～0.283),P=0.018],preoperative hepatic encephalopathy[OR=4.134,95%CI(2.855～5.986),P<0.001],alcoholic liver disease[OR=2.272,95%CI(1.446～3.570),P<0.001],history of alcoholism[OR=1.464,95%CI(1.155～2.032),P<0.001],preoperative RRT[OR=15.610,95%CI(5.486～44.415),P<0.001],preoperative creatinine level[SMD=0.398,95%CI(0.097～0.699),P<0.001],preoperative INR[SMD=0.499,95%CI(0.334～0.664),P<0.001],MELD score[SMD=0.555,95%CI(0.395～0.714),P<0.001],liver cold ischemia time[SMD=0.349,95%CI(0.058～0.639),P=0.019],intraoperative transfusion of concentrated red blood cells[SMD=1.228,95%CI(0.957～1.500),P<0.001],re-liver transplantation[OR=1.799,95%CI(1.001～3.234),P=0.05],postoperative Apache II score[SMD=0.299,95%CI(0.094～0.505),P=0.004],postoperative MV time[SMD=0.714,95%CI(0.302～1.126),P=0.001],postoperative hospitalization time[SMD=1.206,95%CI(0.985～1.428),P<0.001],postoperative ICU stay[SMD=0.537,95%CI(0.363～0.710),P<0.001],postoperative RRT[OR=3.754,95%CI(1.966～7.169),P<0.001],postoperative sepsis[OR=7.029,95%CI(1.602～30.835),P=0.010]are the factors that affect the occurrence of delirium in patients after liver transplantation.Conclusion There are many influencing factors of delirium after liver transplantation,involving demographic baseline characteristics,preoperative,intraoperative and postoperative factors.According to the above 17 influencing factors,medical personnel can identify the high-risk groups of delirium after liver transplantation at an early stage and take preventive measures to reduce the occurrence of delirium.
维普
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