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Introduction <p>Postoperative delirium (POD) is the most common neurologic complication of major surgery with an estimated incidence between 15 to 50%. Various patient demographics have been explored for their impact on POD, but there is limited research analyzing the impact of renal function. Due to the high prevalence of POD as well as the high cost of treatment and possible mortality, additional methods of predicting and subsequently preventing POD are needed.</p> Materials &amp; Methods <p>Three databases were searched for articles containing keywords relating an assessment of preoperative renal function to POD. Articles were screened based on standardized criteria and adjusted odds ratios for associations between preoperative renal function and POD were tabulated.</p> Results <p>Fourteen studies were identified that investigated the effects of preoperative renal function on POD. Out of the 23,384 patients analyzed, 2,785 patients developed POD, indicating an incidence of 11.9%. Chronic kidney disease (OR 2.53, 1.21—5.31, p &lt;.001), decreased glomerular filtration rate (OR 2.05, 1.57—2.66, p &lt;.001), and elevated serum creatinine (OR 1.32, 1.15—1.52, p &lt;.001) were all revealed to be associated with POD based on random effects meta-analysis.</p> Conclusion <p>This review reveals that preoperative renal function is associated with the incidence rate of POD. Overall, renal impairment is a proven predictor for increased risk of POD, affords little cost to physicians, and its consideration in the development of an anesthetic plan may prove to reduce healthcare costs and mortality.</p>

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The Impact of Preoperative Renal Impairment on the Incidence of Postoperative Delirium: A Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年4月12日

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  • Will S. Roberts,
  • Evan Y. Maroun,
  • Alexander D. Knight,
  • Shawn Price,
  • Thomas M. Austin,
  • F. Cole Dooley

摘要

Introduction

Postoperative delirium (POD) is the most common neurologic complication of major surgery with an estimated incidence between 15 to 50%. Various patient demographics have been explored for their impact on POD, but there is limited research analyzing the impact of renal function. Due to the high prevalence of POD as well as the high cost of treatment and possible mortality, additional methods of predicting and subsequently preventing POD are needed.

Materials & Methods

Three databases were searched for articles containing keywords relating an assessment of preoperative renal function to POD. Articles were screened based on standardized criteria and adjusted odds ratios for associations between preoperative renal function and POD were tabulated.

Results

Fourteen studies were identified that investigated the effects of preoperative renal function on POD. Out of the 23,384 patients analyzed, 2,785 patients developed POD, indicating an incidence of 11.9%. Chronic kidney disease (OR 2.53, 1.21—5.31, p <.001), decreased glomerular filtration rate (OR 2.05, 1.57—2.66, p <.001), and elevated serum creatinine (OR 1.32, 1.15—1.52, p <.001) were all revealed to be associated with POD based on random effects meta-analysis.

Conclusion

This review reveals that preoperative renal function is associated with the incidence rate of POD. Overall, renal impairment is a proven predictor for increased risk of POD, affords little cost to physicians, and its consideration in the development of an anesthetic plan may prove to reduce healthcare costs and mortality.