Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for
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Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis Tayler A. Buchan1,2, Behnam Sadeghirad2,3* , Nayeli Schmutz4,5, Nicolai Goettel6,7, Farid Foroutan1,2, Rachel Couban3, Lawrence Mbuagbaw2,8 and Benjamin T. Dodsworth4
Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate welltimed interventions could reduce the occurrence of delirium and the related detrimental outcomes. Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach. Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration: CRD42020171366. Keywords: Postoperative, Prognostic factors, Elderly, Individual patient data meta-analysis
* Correspondence: [email protected] 2 Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada 3 Department of Anesthesia, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitt
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