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Prevalence and influencing factors of postoperative delirium in children undergoing low-risk surgeries: A

Shu-Lan Liu1, Xiao-di Bai1, Ting Xu1

  • 1College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.

Journal of Pediatric Nursing
|April 18, 2026
PubMed

Insights

Postoperative delirium (POD) affects nearly a quarter of children undergoing low-risk surgery. Key risk factors include young age, preoperative anxiety, postoperative pain, and specific surgical types, necessitating targeted interventions.

Area of Science:

  • Pediatric Surgery
  • Neuroscience
  • Critical Care Medicine

Background:

  • Postoperative delirium (POD) is a significant complication in pediatric surgery, linked to adverse outcomes like extended hospital stays, cognitive deficits, and mortality.
  • While extensively studied in critically ill children, particularly after cardiac surgery, its prevalence in low-risk pediatric surgical cases is less understood.
  • This meta-analysis aimed to systematically assess POD prevalence and identify associated risk factors in children undergoing less complex surgical procedures.

Purpose of the Study:

  • To determine the pooled prevalence of postoperative delirium (POD) in pediatric patients undergoing low-risk surgeries.
  • To identify significant risk factors associated with POD in this specific pediatric population.
  • To provide evidence for developing targeted prevention and management strategies for POD in pediatric surgery.

Main Methods:

  • A comprehensive meta-analysis was performed, systematically searching multiple databases (PubMed, Web of Science, Embase, etc.) for relevant studies.
  • Inclusion criteria encompassed studies reporting on POD prevalence and influencing factors in pediatric patients undergoing low-risk surgery.
  • Data synthesis and statistical analysis were conducted using RevMan 5.4 and Stata 15.0, incorporating subgroup, meta-regression, and sensitivity analyses.

Main Results:

  • The meta-analysis included 31 studies with a total of 13,718 pediatric patients.
  • The overall pooled prevalence of POD was found to be 23.4% (95% CI: 0.185-0.286).
  • Significant risk factors identified included younger age (<5 years), preoperative anxiety, postoperative pain, otolaryngologic surgery, and the use of midazolam.

Conclusions:

  • Postoperative delirium (POD) is notably prevalent among children undergoing low-risk surgical procedures.
  • Early identification and intervention focusing on modifiable risk factors such as preoperative anxiety, postoperative pain, and midazolam use are crucial.
  • Particular attention should be directed towards young children (<5 years) and those undergoing otolaryngologic surgeries due to their increased risk.
Abstract

Keywords:
Meta-analysisPediatric patientsPostoperative deliriumPrevalenceRisk factors

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