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Anteayer Journal of Advanced Nursing

Prevalence and risk factors of subsyndromal delirium among postoperative patients: A systematic review and meta‐analysis

Abstract

Aim

The aim of this study is to determine the prevalence and risk factors for subsyndromal delirium in the postoperative patient.

Design

A systematic review and meta-analysis.

Methods

The Review Manager 5.3 statistics platform and the Newcastle-Ottawa Scale were used for quality evaluation.

Data Sources

The following databases were searched: PubMed, Web of Science, EMBASE, The Cochrane Library, Scopus and EBSCO from January 2000 to December 2021. Additional sources were found by looking at relevant articles' citations.

Results

A total of 1744 titles were originally identified, and five studies including 962 patients were included in the systematic review, with a pooled prevalence of postoperative subsyndromal delirium (PSSD) of 30% (95% CI: 0.28–0.32). Significant risk variables for PSSD were older age, low levels of education (≤9 years), cognitive impairment, higher comorbidity score, and the duration of operation.

Conclusion

PSSD is prevalent and is associated with a variety of risk factors as well as low academic performance.

Impact

Identification and clinical management of patients with PSSD should be improved. Future research on PSSD risk factors should look at a wider range of intraoperative and postoperative risk factors that can be changed.

Patient and Public Contribution

No Patient or Public Contribution.

Prevalence and associated factors of chemotherapy‐related cognitive impairment in older breast cancer survivors

Abstract

Aims

To examine the prevalence and associated factors of chemotherapy-related cognitive impairment (CRCI) in older breast cancer survivors (BCS).

Design

Systematic review.

Data Sources

We searched EMBASE, PubMed, PsychInfo, CINAHL, Cochrance Library, Web of Science, CNKI and SinoMed, without language restrictions, for studies published from the establishment of the database to September 2022.

Review Methods

Two researchers independently examined the full texts, data extraction and quality assessment, and any discrepancies were resolved through discussion with a third reviewer. Quality of evidence was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality Scale.

Results

The seven included studies showed that the estimated prevalence of CRCI in older BCS ranged from 18.6% to 27% on objective neuropsychological tests and from 7.6% to 49% on subjective cognitive assessments. The areas most affected were attention, memory, executive functioning and processing speed. CRCI was associated with 10 factors in six categories, including sociodemographic (e.g. age, education level), physiological (e.g. sleep disorders, fatigue and comorbidities), psychological (e.g. anxiety, depression), treatment modalities (e.g. chemotherapy cycles, chemotherapy regimens), genetic (e.g. APOE2, APOE4) and lifestyle factor (e.g. physical inactivity).

Conclusion

CRCI is multifactorial and has a relatively high prevalence. However, the results of subjective and objective cognitive examinations were inconsistent, possibly due to variations in tools used to evaluate different definitions of CRCI. Nevertheless, as there are few published studies of older BCS, this conclusion still require verification by well-designed studies in the future.

Impact

We found that the prevalence of CRCI in older adults is relatively high and multifactorial, providing evidence for further health care for this population.

No Patient or Public Contribution

There was no patient or public involvement.

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