Meta-analysis of the incidence and risk factors of postoperative delirium in organ transplant patients

Table 1 Literature information reporting the incidence of postoperative delirium in organ transplant patients during 2020-2024

Ref.	Country/region	Research type	Age (year)	Male	Transplanted organ	POD evaluation	N1	n2	NOS
Ahmed et al[9], 2021	Ontario, Canada	Prospective	57.1 ± 13.6	55%	Heart/lung	NA	78	28	8
Chang et al[10], 2022	Taiwan, China	Retrospective	50.57 ± 7.59	94.05%	Liver	CAM-ICU	84	46	8
Chen et al[11], 2020	Hunan, China	Retrospective	48.29 ± 9.14	84.28%	Liver	CAM-ICU	159	42	8
Cheng et al[12], 2020	Chengdu, China	Retrospective	NA	NA	Liver	CAM-ICU	242	36	7
Chu et al[13], 2022	MD, United States	Retrospective	NA	NA	Kidney	NA	894	43	7
Dalton et al[14], 2022	NC, United States	Retrospective	63.0 ± 6.4	65%	Lung	NA	100	38	7
DeBolt et al[15], 2021	San Francisco, United States	Retrospective	57 ± 11.5	141/143	Lung	CAM	236	34	9
Dragnich et al[16], 2023	TN, United States	Retrospective	49.8 ± 15.7	59%	Lung	CAM-ICU	60	28	9
Ebner et al[17], 2023	FL, United States	Retrospective	NA	NA	Heart	NA	25371	1482	7
Jin et al[18], 2023	Beijing, China	Retrospective	22-67	60.00%	Liver	NA	250	29	8
Kaderi et al[19], 2024	CA, United States	Retrospective	NA	NA	Lung	CAM	27	9	7
Khalil et al[20], 2020	Giza, Egypt	Retrospective	50.16 ± 8.38	90.60%	Liver	NA	149	20	8
Lee et al[21], 2021	Seoul, Korea	Prospective	NA	NA	Liver	NA	201	15	7
Lee et al[22], 2024	Seoul, Korea	Retrospective	NA	NA	Kidney	NA	296	14	7
Long et al[23], 2024	NY, United States	Retrospective	NA	NA	Kidney	NA	735	80	7
Lu et al[24], 2022	Hangzhou, China	Retrospective	52 ± 10	84.30%	Liver	DSM-IV	402	78	9
Ma et al[25], 2023	Changsha, China	Retrospective	47.1 ± 10.0	82.20%	Liver	CAM-ICU	321	62	9
Ma et al[26], 2023	Changsha, China	Retrospective	46.2 ± 9.8	82.94%	Liver	CAM-ICU	211	43	9
Mottaghi et al[27], 2022	Shiraz, Iran	Prospective	NA	NA	Liver	CAM-ICU	227	52	7
Mubashir et al[28], 2022	TN, United States	Retrospective	NA	NA	Lung	CAM-ICU	136	32	7
Ozay et al[29], 2022	Ankara, Turkey	Prospective	mean: 47.56	83.10%	Lung	NA	77	40	9
Park et al[30], 2020	Ansan, Korea	Retrospective	53.66 ± 7.93	27.69%	Liver	DSM-IV	325	69	9
Patel et al[31], 2024	FL, United States	Retrospective	2.0 (0.9, 8.5)	51%	Liver	CAM-ICU	63	47	9
			mean: 14.0	68%	Kidney	CAM-ICU	63	9	9
			mean: 4.0	63.33%	Intestinal	CAM-ICU	30	24	9
Patrono et al[32], 2020	Turin, Italy	Retrospective	NA	74.51%	Liver	CAM	306	41	8
Ri et al[33], 2020	Yangsan, Korea	Retrospective	53.53 ± 8.03	23.53%	Liver	DSM-IV	136	15	9
Ruck et al[34], 2024	United States	Retrospective	≥ 55	NA	Kidney	NA	35800	322	7
Tavabie et al[35], 2020	London, United Kingdom	Retrospective	≥ 18	NA	Liver	NA	793	113	7
Vandiver et al[36], 2022	CA, United States	Retrospective	58.4 ± 11.4	58%	Lung	CAM-ICU	114	50	9
Zhan et al[37], 2024	Hubei, China	Retrospective	53.34 ± 6.97	82.05%	Lung	NA	39	9	8

¹The total number of patients included in the study.

²The number of cases in which postoperative delirium occurred.

POD: Postoperative delirium; NOS: Newcastle-Ottawa Scale; NA: Not available; CAM: Confusion assessment method; ICU: Intensive care unit; DSM: Diagnostic and Statistical Manual of Mental Disorders.

Table 2 presents the literature information regarding the risk factors of postoperative delirium in organ transplant patients

Ref.	Country/region	Research type	Age (year)	Male	Transplanted organ	POD evaluation	Risk factor	NOS
Anderson et al[38], 2018	PA, United States	Retrospective	mean: 61	63.23%	Lung	NA	a/b	8
Binda et al[39], 2017	Italian	Retrospective	NA	NA	Liver	CAM-ICU	c/d	7
Haugen et al[40], 2018	United States	Retrospective	50.3 ± 13.7	61.40%	Kidney	NA	a	8
Lee et al[41], 2013	Korea	Retrospective	51.00 ± 9.570	74.40%	Liver	DSM-IV	a/f	9
Lee et al[42], 2018	Korea	Retrospective	mean: 54	70.35%	Liver	CAM	f/d/g	9
Lescot et al[43], 2013	France	Retrospective	mean: 60	64.30%	Liver	DSM-IV	d	9
Ma et al[25], 2023	Changsha, China	Retrospective	47.1 ± 10.0	82.2%	Liver	CAM-ICU	i/c/f	9
Smith et al[44], 2018	NC, United States	Retrospective	mean: 54.5	59%	Lung	NA	b/h	8
Wang et al[45], 2014	Taiwan, China	Retrospective	53.40 ± 8.40	74.40%	Liver	RASS	e/c/d/g	9
Yoon et al[46], 2009	Seoul, Korea	Retrospective	50.05 ± 8.05	80.16%	Liver	DSM-IV	e/c/g	9

“e” was reported by Chang et al[10] in 2022; “c/f” was reported by Chen et al[11] in 2020; “a/h” was reported by Lee et al[22] in 2024; “f/c/I” was reported by Ma et al[25] in 2023; “a” was reported by Ruck et al[34] in 2024; “j” was reported by Park et al[30] in 2020 and Ri et al[33] in 2020. POD: Postoperative delirium; NOS: Newcastle-Ottawa Scale; NA: Not available; CAM: Confusion assessment method; ICU: Intensive care unit; DSM: Diagnostic and Statistical Manual of Mental Disorders; RASS: Richmond Agitation-Sedation Scale; a: Age; b: Primary graft dysfunction; c: History of hepatic encephalopathy; d: Acute Physiologic and Health Evaluation II score; e: Alcohol abuse history; f: Preoperative model for end stage liver disease score; g: Endotracheal intubation (day); h: Psychotropic medications use; i: Preoperative infections; j: With diuretics.