Abstract 113: Incidence and Risk Factors of Delirium After Neurointerventions: A Systematic Review and Meta‐Analysis

IntroductionPostoperative delirium (POD) is a prevalent and serious complication following neurointerventions, significantly impacting patient recovery, healthcare costs, and long‐term outcomes. This systematic review and meta‐analysis aim to synthesize the existing literature on the incidence and risk factors of POD in neurosurgical patients, providing insights to inform clinical practices and future research.MethodsWe conducted a comprehensive search of electronic databases, including PubMed, Scopus, and the Cochrane Library, for studies published up to October 2023. Inclusion criteria comprised cohort and case‐control studies focusing on adult patients undergoing neurointerventions. The primary outcome was the incidence of delirium, assessed solely in the delirium group. Secondary outcomes included age, gender, and procedure duration, analyzed across both delirium and non‐delirium groups. Our meta‐analysis utilized a fixed‐effect model to calculate pooled incidence rates and effect sizes, and the quality of included studies was assessed using the Newcastle‐Ottawa Scale for observational studies.ResultsOur single‐arm meta‐analysis of 30 studies involving 12,714 neurosurgical patients revealed a statistically significant pooled incidence of POD at 22% (95% CI: 18‐25, p < 0.001). Advanced age was identified as a significant risk factor, with a pooled effect size of 0.46 (95% CI: 0.41‐0.51, p < 0.00001). Additionally, longer surgical duration was significantly associated with an increased risk of POD, showing an effect size of 0.24 (95% CI: 0.18‐0.31, p < 0.00001). Analyzing gender, we found that males had a higher pooled effect size related to POD at 0.54 (95% CI: 0.51‐0.57, p = 0.009). These findings underscore the need for targeted interventions and vigilant monitoring of at‐risk patients.ConclusionThis review and meta‐analysis highlight the significant incidence of postoperative delirium following neurointerventions, with advanced age and prolonged surgical duration as key risk factors. POD is linked to longer hospital stays and increased postoperative complications. These findings emphasize the importance of early detection and standardized management strategies to enhance patient outcomes. Future research should focus on preventive interventions and the long‐term effects of POD on cognitive function and quality of life.