Highlights
- •Here, we first report specific risk factors for delirium in advanced cancer patients as identified via meta-analysis.
- •This study reports 12 independent risk factors and details the strength of their associations via pooled analyses.
- •Our evidence-based risk stratification to guide clinical management of delirium in advanced cancer patients.
Abstract
Purpose
To systematically collect published research in order to identify and quantify risk
factors for delirium in advanced cancer patients.
Methods
The Cochrane Library, PubMed, Proquest, CINAHL, Web of Science, Ovid MEDLINE, Embase,
Scopus, Chinese Wanfang Data, Chinese Periodical Full-text Database (VIP), Chinese
Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure
(CNKI) were systematically searched for cohort or case-control studies reporting individual
risk factors for delirium among advanced-stage cancer patients published prior to
March 2022. The Newcastle-Ottawa Scale was used to assess the methodological quality
of included studies. The pooled adjusted odds ratio (aOR) and its 95% confidence interval
were calculated using the RevMan 5.4 software package.
Results
A total of 15 studies with data from 3106 advanced cancer patients were included in
our analysis. Nine studies were high-quality and six were of moderate quality. Pooled
analyses revealed that 11 risk factors were statistically significant. High-intensity
risk factors included sleep disturbance, infection, cachexia and the Palliative Prognostic
Index; medium-intensity risk factors included male sex, renal failure, dehydration
and drowsiness; low-intensity risk factors included age, total bilirubin and opioid
use. Antibiotic use was found to have been a protective factor.
Conclusions
We identified 12 independent risk factors that were significantly associated with
delirium in advanced cancer patients and provide an evidence-based foundation to implement
appropriate preventive strategies.
Keywords
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Article info
Publication history
Published online: January 07, 2023
Accepted:
January 2,
2023
Received in revised form:
December 17,
2022
Received:
September 17,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
