Risk factors for postoperative delirium after Stanford type A aortic dissection:A systematic review and meta-analysis
Objective To systematically evaluate the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection.Methods We searched the CNKI,SinoMed,Wanfang data,VIP,PubMed,Web of Science,EMbase,The Cochrane Library database from inception to September 2022.Case-control studies,and cohort studies on risk factors for postoperative delirium after surgery for Stanford type A aortic dissection were collected to identify studies about the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection.Quality of the included studies was evaluated by the Newcastle-Ottawa scale(NOS).The meta-analysis was performed by RevMan 5.3 software and Stata 15.0 software.Results A total of 21 studies were included involving 3 385 patients.The NOS score was 7-8 points.The results of meta-analysis showed that age(MD=2.58,95％CI 1.44 to 3.72,P＜0.00 001),male(OR=1.33,95％CI 1.12 to 1.59,P=0.001),drinking history(OR=1.45,95％CI 1.04 to 2.04,P=0.03),diabetes history(OR=1.44,95％CI 1.12 to 1.85,P=0.005),preoperative leukocytes(MD=1.17,95％CI 0.57 to 1.77),P=0.000 1),operation time(MD=21.82,95％CI 5.84 to 37.80,P=0.007),deep hypothermic circulatory arrest(DHCA)time(MD=3.02,95％CI 1.04 to 5.01,P=0.003),aortic occlusion time(MD=8.94,95％CI 2.91 to 14.97,P=0.004),cardiopulmonary bypass time(MD=13.92,95％CI 5.92 to 21.91,P=0.0006),ICU stay(MD=2.77,95％CI 1.55 to 3.99,P＜0.000 01),hospital stay(MD=3.46,95％CI 2.03 to 4.89,P＜0.000 1),APACHE Ⅱ score(MD=2.76,95％CI 1.59 to 3.93,P＜0.000 01),ventilation support time(MD=6.10,95％CI 3.48 to 8.72,P＜0.000 01),hypoxemia(OR=2.32,95％CI 1.40 to 3.82,P=0.001),the minimum postoperative oxygenation index(MD=-79.52,95％CI-125.80 to-33.24,P=0.000 8),blood oxygen saturation(MD=-3.50,95％CI-4.49 to-2.51,P＜0.000 01),postoperative hemoglobin(MD=-6.35,95％CI-9.21 to-3.50,P＜0.000 1),postoperative blood lactate(MD=0.45,95％CI 0.15 to 0.75,P=0.004),postoperative electrolyte abnormalities(OR=5.94,95％CI 3.50 to 10.09,P＜0.000 01),acute kidney injury(OR=1.92,95％CI 1.34 to 2.75,P=0.000 4)and postoperative body temperature(MD=0.79,95％CI 0.69 to 0.88,P＜0.000 01)were associated with postoperative delirium after surgery for Stanford type A aortic dissection.Conclusion The current evidence shows that age,male,drinking history,diabetes history,operation time,DHCA time,aortic occlusion time,cardiopulmonary bypass time,ICU stay,hospital stay,APACHE 11 score,ventilation support time,hypoxemia and postoperative body temperature are risk factors for the postoperative delirium after surgery for Stanford type A aortic dissection.Oxygenation index,oxygen saturation,and hemoglobin number are protective factors for delirium after Stanford type A aortic dissection.
Stanford type A aortic dissectionpostoperative deliriumrisk factorssystematic review/meta-analysis
万方数据
维普
