Table 1 General characteristics of the included studies
Study | Design | Population | Sample size | POD assessment | Diagnosis frequency and duration | POD incidence (%) | Study quality score |
|---|---|---|---|---|---|---|---|
Fang 2016 [18] | Case–control study | Inclusion criteria: underwent TAAD surgery Exclusion criteria: (1) age < 18 or > 65; (2) delirium, psychosis, mental retardation, and low cognitive level before surgery; (3) stroke before surgery; (4) death during surgery; (5) lack of consciousness after surgery; (6) ICU stay < 24 h; (7) incomplete data collection | 335 | CAM-ICU | Start 24 h after surgery, every 8 h until the 10th postoperative day or leaving the ICU | 50.4 | 8 |
Song 2016 [19] | Case–control study | Inclusion criteria: underwent TAAD surgery and were followed in the cardiac care unit Exclusion criteria: (1) delirium or mental illness diagnosis before surgery; (2) failure to recover from postoperative coma; (3) age < 18; (4) perioperative death; (5) ICU stay < 24 h; (6) incomplete data collection | 148 | CAM-ICU | 3 times a day (7:00, 15:00, 23:00) | 31.1 | 8 |
Liu 2017 [15] | Case–control study | Inclusion criteria: TAAD patients after Sun’s procedure in the cardiac surgical intensive care unit, with or without aortic valve replacement Exclusion criteria: (1) preoperative mental disease diagnosis; (2) inability to wake from surgery; (3) death during or within 24 h of surgery; (4) incomplete data collection | 100 | CAM-ICU | Every 4 h postoperatively until patients left the ICU | 34 | 8 |
Shi 2019 [20] | Case–control study | Inclusion criteria: underwent Sun operation in the cardiac surgery ICU Exclusion criteria: death or discharge from hospital | 148 | CAM-ICU | NS | 45.95 | 8 |
Lin 2020 [21] | Cohort study | Inclusion criteria: (1) age 18 – 75 years; (2) consent and volunteering to participate in this study Exclusion criteria: (1) brain injury history; (2) congenital deaf-mute; (3) postoperative ICU stay < 24 h; (4) continuous deep sedation with propofol and remifentanil after surgery | 280 | CAM-ICU | From the 1st day after surgery lasting until the 5th day after surgery | 37.86 | 8 |
Cai 2020 [22] | Case–control study | Inclusion criteria: the diagnosis included in TAAD was CT angiography Exclusion criteria: mental disorders | 301 | CAM-ICU | NS | 24.25 | 9 |
Lin 2021 [23] | Cohort study | Inclusion criteria: underwent TAAD surgery Exclusion criteria: less than 48Â h stay in ICU after the operation, transcranial trauma history, congenital deafness or schizophrenia, epilepsy before surgery, using glucocorticoids for a long time, remaining in a coma | 257 | CAM-ICU | From 8:00 to 11:00, 15:00 to 17:00, and 20:00 to 23:00 on the first day after surgery, until delirium occurred or the patient was transferred out of ICU | 40.08 | 9 |
Lv 2021 [14] | Case–control study | Inclusion criteria: (1) age > 18 years; (2) surgical repair combined with open triple-branched stent graft placement; (3) signed informed consent Exclusion criteria: (1) prior neurological or psychiatric diseases; (2) liver cirrhosis and uremia; (3) preoperative stroke or brain malperfusion; (4) preoperative shock or hemodynamic instability due to cardiac tamponade; (5) liver enzymes greater than four times the baseline; (6) hearing or visual impairment; (7) comatose after surgery or died within 24 h after the surgery; (8) extracorporeal membrane oxygenation therapy | 221 | CAM-ICU | After the first 3 postoperative days, delirium was evaluated twice daily in ICU or the general ward | 14.03 | 8 |
Li2022 [24] | Case–control study | Inclusion criteria: (1) TAAD; (2) no history of delirium; (3) underwent surgical treatment Exclusion criteria: (1) death during hospitalization; (2) withdrawal of treatment due to deterioration of primary disease; (3) cerebrovascular sequelae; (4) history of mental illness, alcohol, or drug abuse | 245 | DSM-5 | NS | 20.82 | 8 |