January 17, 2024

Publication in JAMA Network - Perioperative Factors Associated With Postoperative Delirium in Patients Undergoing Noncardiac Surgery: An Individual Patient Data Meta-Analysis

In the paper, titled "Perioperative Factors Associated With Postoperative Delirium in Patients Undergoing Noncardiac Surgery: An Individual Patient Data Meta-Analysis," Sadeghirad et al. performed a comprehensive meta-analysis of individual patient data (IPD) to identify and assess perioperative factors associated with POD among adults undergoing noncardiac surgery. While we have seen various meta-analyses on this topic, a meta-analysis of individual patient data (IPD) pools and analyzes raw, individual-level data from original studies, allowing for more precise and detailed analysis than a conventional meta-analysis which “only” combines and analyzes summary statistics.

To perform the analysis, the authors first performed a systematic review and then collected IPD from 21 studies involving 8,382 patients who underwent noncardiac surgery. The analysis then revealed that approximately 18% of these patients developed POD. Several significant risk factors for POD were identified, including higher American Society of Anesthesiologists (ASA) status, older age, low body mass index, history of delirium, preoperative cognitive impairment, and elevated preoperative C-reactive protein levels. In contrast, higher education levels were associated with a decreased likelihood of developing POD.