Systematic review of clinical evidence on postoperative delirium: literature search of original studies based on validated diagnostic scales

• Published in: Journal of Anesthesia, Analgesia and Critical Care (Online) Vol. 1; no. 1; p. 18
• Main Authors: Bilotta, F, Russo, G, Verrengia, M, Sportelli, A, Foti, L, Villa, G, Romagnoli, S
• Format: Journal Article
• Language: English
• Published: England Springer Nature B.V 25-11-2021; BioMed Central; BMC
• Subjects: Confused assessment method; Delirium; Evidence-based medicine; Guidelines; Intensive care; Level of evidence; Medical diagnosis; Mental disorders; Orthopedics; Postoperative delirium; Review; Surgery; Systematic review; Validated diagnostic postoperative delirium scales; Level of evidence; Validated diagnostic postoperative delirium scales; Postoperative delirium; Evidence-based medicine; Confused assessment method; Guidelines
• ISSN: 2731-3786; 2731-3786
• DOI: 10.1186/s44158-021-00021-8

Postoperative delirium is a serious complication that can occur within the 5th postoperative day. In 2017, the European Society of Anesthesiologists delivered dedicated guidelines that reported the need for routine monitoring using validated scales.
Aim of this systematic review is to identify clinical studies related to postoperative delirium that included postoperative monitoring with validated scales.
Systematic review METHODS: Searched keywords included the following terms: postoperative, postsurgical, post anesthesia, anesthesia recovery, delirium, and confusion. Two researchers independently screened retrieved studies using a data extraction form.
Literature search led to retrieve 6475 hits; of these, 260 studies (5.6% of the retrieved), published between 1987 and 2021, included in their methods a diagnostic workup with the use of a postoperative delirium validated scale and monitored patients for more than 24 h, therefore are qualified to be included in the present systematic review.
In conclusion, available clinical literature on postoperative delirium relies on a limited number of studies, that included a validated diagnostic workup based on validated scales, extracted from a large series of studies that used inconsistent diagnostic criteria. In order to extract indications based on reliable evidence-based criteria, these are the studies that should be selectively considered. The analysis of these studies can also serve to design future projects and to test clinical hypothesis with a more standardized methodological approach.