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What is the impact of perioperative cerebral oxygen desaturation on postoperative delirium in old population: a systemic review and meta-analysis

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Abstract

Background

Perioperative cerebral oxygen saturation (ScO2) has been reported to associate with postoperative delirium (POD) which is a common postoperative complication, however, the results were inconclusive. Therefore, we aimed to conduct an up-to-date review and meta-analyze the relationship between perioperative ScO2 and POD.

Methods

We systematically searched PubMed, Embase and Web of science through January 13, 2022. The pooled results were estimated through a random-effects model meta-analysis and expressed as odds ratios (ORs) and standard mean differences (SMDs), accompanied with 95% confident intervals (CIs).

Results

Finally, of 467 searched articles, ten articles were included. A total of six studies reported the baseline ScO2 value and the pooled result showed that preoperative baseline ScO2 was lower in POD groups (SMD = − 0.41, 95% CI − 0.64 to − 0.18). And beyond that, the pooled OR across four literatures about preoperative low ScO2 on POD was 3.44 (95% CI 1.69, 7.02). In contrast, insignificant differences were detected in baseline/lowest ScO2 value during intraoperative and postoperative period. Additionally, there were no statistically significant associations for intraoperative and postoperative low ScO2 effect on POD risk. Meta-regress analysis has found no significant impact factors.

Conclusions

Based on current evidence, POD patients have a lower ScO2, and ScO2 desaturation may increase POD incidence, indicating the role of ScO2 underlying pathological mechanisms. For generalizability of evidence, we should rely on high-quality, considering more comprehensively longitudinal, interdisciplinary studies.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

This work was supported by the Fundamental Research Funds for the Central Universities (New medicine of USTC, WK9110000082), Postdoctoral funded projects in Anhui Province (2019B301) and Funding for key disciplines of Anesthesiology (13th five-year plan, ZD135_0005).

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Authors and Affiliations

  1. Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China

    Ke-qiang He, Sheng Wang, Wei Zhang & Xiao-qing Chai

  2. Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine , University of Science and Technology of China, Hefei, 230001, China

    Ke-qiang He & Qiang Liu

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  1. Ke-qiang He
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  2. Sheng Wang
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Contributions

K-QH contributed to study concept and design; K-QH, SW, WZ, QL took part in acquisition of data including risk of bias assessment; K-QH, QL involved in analysis and interpretation of data; K-QH, X-QC took part in drafting of the manuscript; all declared authors participated in critical revision of the manuscript for important intellectual content; administrative, technical, or material support is not applicable; K-QH, X-QC involved in study supervision. All authors read and approved the final manuscript.

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Correspondence to Qiang Liu or Xiao-qing Chai.

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He, Kq., Wang, S., Zhang, W. et al. What is the impact of perioperative cerebral oxygen desaturation on postoperative delirium in old population: a systemic review and meta-analysis. Aging Clin Exp Res 34, 1761–1770 (2022). https://doi.org/10.1007/s40520-022-02128-6

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  • DOI: https://doi.org/10.1007/s40520-022-02128-6

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