结直肠癌患者术后谵妄危险因素的Meta分析

Meta-analysis of risk factors for postoperative delirium in patients with colorectal cancer

目的基于Meta分析探讨结直肠癌患者术后谵妄的危险因素。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库,选取各数据库建库至2022年4月6日公开发表的关于结直肠癌术后谵妄影响因素的文献,由2名研究者独立筛选文献、提取资料,并采用纽卡斯尔-渥太华量表对文献质量进行评价,采用Stata 15.0统计学软件对纳入文献进行Meta分析。结果共纳入19篇文献,包含5295例患者。Meta分析结果显示,结直肠癌患者术后谵妄发生的各因素合并比值比(OR)值和95%置信区间(95%CI)分别为:高龄[1.10(1.06~1.14)]、男性[2.29(1.81~4.44)]、酗酒[3.14(1.63~6.06)]、术前身体状态分级(≥3级)[1.47(1.13~1.91)]、合并症[1.59(1.16~2.17)]、精神疾病史[7.86(4.57~13.54)]、脑血管病史[5.74(3.78~8.72)]、认知功能障碍[3.31(1.20~9.08)]、白蛋白[0.81(0.66~0.99)]、围手术期输血[2.29(1.41~3.69)]、C反应蛋白[2.24(1.11~4.53)],均P<0.05。结论高龄、男性、酗酒、术前身体状态分级≥3级、合并糖尿病等基础疾病、精神疾病史、脑血管病史、认知功能障碍、低白蛋白、围手术期输血、C反应蛋白升高是结直肠癌患者术后发生谵妄的危险因素。

ObjectiveTo explore the risk factors for postoperative delirium in colorectal cancer patients based on Meta-analysis.MethodsA computer search was conducted on PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,VIP and China Biology Medicine disc,and literatures on influencing factors of postoperative delirium of colorectal cancer published by each database until April 6,2022 were selected.Two researchers independently screened the literature,extracted the data,and evaluated the quality of the literature using Newcastle-Ottawa Scale(NOS).Stata 15.0 statistical software was used to conduct a Meta-analysis of the included literatures.ResultsA total of 19 articles were included,including 5295 patients.The Meta-analysis results showed that the combined odds ratio(OR)values and 95%confidence interval(95%CI)of various factors for postoperative delirium in colorectal cancer patients were advanced age[1.10(1.06-1.14)],male[2.29(1.81-4.44)],alcohol abuse[3.14(1.63-6.06)],preoperative physical condition grading(≥level 3)[1.47(1.13-1.91)],comorbidities[1.59(1.16-2.17)],history of mental illness[7.86(4.57-13.54)],history of cerebrovascular disease[5.74(3.78-8.72)],cognitive impairment[3.31(1.20-9.08)],albumin[0.81(0.66-0.99)],perioperative blood transfusion[2.29(1.41-3.69)]and C-reactive protein[2.24(1.11-4.53)],all P<0.05.ConclusionsThe risk factors for delirium in colorectal cancer patients after operation are old age,male,alcoholism,preoperative physical condition grading≥level 3,combined diabetes and other basic diseases,history of mental disease,history of cerebrovascular disease,cognitive dysfunction,low albumin,perioperative blood transfusion and elevated C-reactive protein.