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Centre for Policy on Ageing | |
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The incidence of delirium associated with orthopedic surgery
— a meta-analytic review | | Author(s) | Angela J Bruce, Craig W Ritchie, Robert Blizard |
| Journal title | International Psychogeriatrics, vol 19, no 2, April 2007 |
| Pages | pp 197-214 |
| Keywords | Confusion ; Orthopaedics ; Correlation ; Literature reviews. |
| Annotation | A systematic review and meta-analysis of the literature on the incidence of delirium in patients following orthopaedic surgery was conducted, by sourcing relevant papers from online databases and grey literature. Included studies used a validated diagnostic method to measure the incidence of delirium in a prospective sample of adult and older orthopaedic patients. Data were subject to meta-analysis after stratification by type of surgery (elective vs emergency) and inclusion or exclusion of pre-existing cognitive impairment. A funnel plot assessed for publication bias. 26 publications reported an incidence of post-operative delirium of 4% to 53.3% in hip samples and 3.6% to 38.3% in elective samples. Significant heterogeneity was evident, and this persisted despite stratification. Hip fracture was associated with a higher risk of delirium than elective surgery both when the cognitively impaired were included in the sample (random effects pooled estimate = 21.7% vs 12.1%), and when the cognitively impaired were excluded (random effects pooled estimate = 25% vs 8.8%) The funnel plot showed a deficit of small studies showing low risk and large studies showing high risk. In 8 hip fracture studies, the proportion of delirium cases with a pre-operative onset ranged from 34% to 92%. Delirium occurs more commonly with hip fracture than elective surgery, and frequently has a pre-operative onset when associated with trauma. Recommendations are made with the aim of standardising future research, in order to further explore and reduce the heterogeneity and possible publication bias observed. (RH). |
| Accession Number | CPA-090825202 A |
| Classmark | EDC: LKB: 49: 64A |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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