Risk prediction models for postoperative delirium in elderly patients with hip fracture: a systematic review

Frontiers in Medicine

Medicine

Dongying Li¹  Yaqi Hua²  Ping Tu³  Jianting Zhu⁴  Liping Liu⁴  Xin Wang⁴  Yi Yuan⁵ 

[1] Department of Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;Department of Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;School of Nursing, Nanchang University, Nanchang, Jiangxi, China;Department of Postanesthesia Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;School of Nursing, Nanchang University, Nanchang, Jiangxi, China;School of Nursing, University of South China, Hengyang, Hunan, China;

关键词: hip fracture;    postoperative delirium;    prediction;    models;    systematic review;   

DOI  :  10.3389/fmed.2023.1226473

 received in 2023-06-08, accepted in 2023-08-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesTo systematically evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients.MethodsRisk prediction models for postoperative delirium in older adult hip fracture patients were collected from the Cochrane Library, PubMed, Web of Science, and Ovid via the internet, covering studies from the establishment of the databases to March 15, 2023. Two researchers independently screened the literature, extracted data, and used Stata 13.0 for meta-analysis of predictive factors and the Prediction Model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients, evaluated the predictive performance.ResultsThis analysis included eight studies. Six studies used internal validation to assess the predictive models, while one combined both internal and external validation. The Area Under Curve (AUC) for the models ranged from 0.67 to 0.79. The most common predictors were preoperative dementia or dementia history (OR = 3.123, 95% CI 2.108–4.626, p < 0.001), American Society of Anesthesiologists (ASA) classification (OR = 2.343, 95% CI 1.146–4.789, p < 0.05), and age (OR = 1.615, 95% CI 1.387–1.880, p < 0.001). This meta-analysis shows that these were independent risk factors for postoperative delirium in older adult patients with hip fracture.ConclusionResearch on the risk prediction models for postoperative delirium in older adult hip fracture patients is still in the developmental stage. The predictive performance of some of the established models achieve expectation and the applicable risk of all models is low, but there are also problems such as high risk of bias and lack of external validation. Medical professionals should select existing models and validate and optimize them with large samples from multiple centers according to their actual situation. It is more recommended to carry out a large sample of prospective studies to build prediction models.Systematic review registrationThe protocol for this systematic review was published in the International Prospective Register of Systematic Reviews (PROSPERO) under the registered number CRD42022365258.

【 授权许可】

Unknown   
Copyright © 2023 Hua, Yuan, Wang, Liu, Zhu, Li and Tu.