Risk factors for delirium after hip arthroplasty: An umbrella meta-analysis

Postoperative delirium is a common complication in elderly patients after hip arthroplasty, which can lead to a prolonged hospital stay and decreased quality of life.The aim of this study was to evaluate the risk factors of delirium after hip arthroplasty in the elderly by umbrella meta-analysis and to provide reference value for the clinical development of effective prevention and intervention strategies.

A systematic search was conducted in PubMed, Web of Science, and the Cochrane Library to identify relevant meta-analyses on postoperative delirium. Umbrella meta-analysis was applied to analyze various risk factors and assess their association with the occurrence of postoperative delirium. Subgroup analyses were performed to examine the heterogeneity of these factors across different patient populations.

We identified several significant risk factors for postoperative delirium, including older age, dementia, diabetes mellitus, type of anesthesia (general versus regional anesthesia), heart failure, stroke history, postoperative sedation medication, preoperative cognitive impairment, and surgery duration. Subgroup analyses indicated substantial variability in the effect sizes of these factors, suggesting differences in risk characteristics across various patient groups.

In this umbrella meta-analysis, we highlighted multiple independent risk factors for postoperative delirium following hip arthroplasty, such as advanced age, dementia, diabetes, anesthesia type, heart failure, stroke history, postoperative sedative medication use, preoperative cognitive impairment, and surgical duration. We emphasized the need for individualized prevention and intervention strategies.

This method to identify the risk factors of postoperative delirium in patients undergoing hip arthroplasty could effectively guide healthcare providers to formulate personalized prevention and intervention strategies, which might improve the prognosis of patients and reduce medical costs.

PROSPERO(CRD420251018204.).