Impact of preoperative malnutrition on postoperative delirium incidence in elderly surgical patients:a Meta analysis

LI Feng; LI Naiyan; SHAO Mingzhu

doi:10.12102/j.issn.2095-8668.2024.23.004

Abstract：Objective:To understand the current status of postoperative delirium in elderly surgical patients with preoperative malnutrition,and to explore the influencing factors of preoperative malnutrition and postoperative delirium.Methods:Literature about postoperative delirium in elderly surgical patients with preoperative malnutrition were searched in PubMed,CINAHL,EMbase,the Cochrane Library,Web of Science,CNKI,WanFang Database,VIP,CBM.The retrieval time was from April 1,2013 to April 30,2023.Meta-analysis was performed on the literature that met the inclusion criteria using RevMan 5.3 software.Results:A total of 15 articles and 4 374 patients were included.The incidence of postoperative delirium in elderly surgical patients with preoperative malnutrition ranged from 15.90％to 87.19％.The results of Meta-analysis showed that the incidence of postoperative delirium in elderly surgical patients with malnutrition risk and malnutrition was 30％(95％CI 0.24-0.35,P＜0.000 01)and 48％(95％CI 0.37-0.59,P＜0.000 01).Preoperative malnutrition risk and malnutrition were both factors affecting postoperative delirium.Elderly surgical patients with preoperative malnutrition risk and malnutrition had about 2.37 times,1.88 times the risk of suffering postoperative delirium higher than those with normal nutrition.Conclusion:Current evidence shows that the incidence of postoperative delirium is higher in elderly surgical patients with preoperative malnutrition.Preoperative malnutrition risk and malnutrition are both factors affecting postoperative delirium.The elderly surgical patients with preoperative malnutrition risk and malnutrition have a higher risk of postoperative delirium,nursing interventions are necessary to improve the preoperative malnutrition status of preoperative malnutrition to prevent postoperative delirium.