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Impact of early neurocognitive disorders following surgery on clinical outcomes: a comprehensive meta‑analysisтезисы доклада
- Авторы: Likhvantsev V., Landoni G., Berikashvili L., Ermokhina N., Yadgarov M., YmKotani, Kadantseva K., Makarevich D., Grechko A.
- Сборник: Critical Care 2024 43rd International Symposium on Intensive Care & Emergency Medicine
- Серия: Suppl 1
- Том: 68
- Тезисы
- Год издания: 2024
- Место издания: BMC Брюссель, Бельгия
- Первая страница: 020
- Номер статьи: P020
- DOI: 10.1186/s13054-024-04822-5
- Аннотация: Introduction: Early postoperative neurocognitive disorders (PND),manifesting as emergence delirium and emergence agitation,remain among the least explored aspects of perioperative neurocognitive disorders. This meta-analysis primarily aims to assessthe infuence of early PND (ePND) on outcomes that hold clinicalsignifcance.Methods: We conducted a systematic review of studies publishedover the past 20 years using Medline, PubMed, Google Scholar, andCochrane Library. The protocol of this study was registered on PROSPERO (CRD 42022382008). The inclusion criteria focused on adultswith emergence agitation and/or emergence delirium, and outcomesincluded mortality, postoperative delirium, and length of post-anesthesia care unit and hospital stay. The studies’ internal validity, risk ofbias, and certainty of evidence were assessed.Results: This meta-analysis synthesized data from 22 studies, encompassing a total patient cohort of 15,935. We observed that ePNDwere present in 16% of these patients. Notably, the mortality rate forpatients with ePND stood at 2.4%, which was double the rate of 1.2%in patients who experienced normal cognitive emergence post-surgery (odds ratio of 2.7, p=0.01). Furthermore, postoperative deliriumwas signifcantly more prevalent in the ePND group, afecting 29%,in stark contrast to just 4.6% in those with normal emergence—a15-fold increase as indicated by an odds ratio of 15.7 (relative risk 9.4,p<0.001) (Figure). ePND was associated with longer post-anesthesiaand hospital stays (p=0.004 and p<0.001, respectively).Conclusions: The meta-analysis indicates that ePND is associated witha doubled risk of all-cause mortality and a ninefold increase in postoperative delirium, highlighting the need for further research andimproved clinical approaches to ePND management.
- Добавил в систему: Ядгаров Михаил Яковлевич