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Risk factors for postoperative delirium after colorectal surgery: a systematic review and meta-analysis

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Postoperative delirium is common after any type of surgery and can lead to serious outcomes; thus, its prevention is important. Early assessment can help identify patients at higher risk of postoperative delirium. However, the risk factors for postoperative delirium in patients who underwent colorectal surgery are unclear. This meta-analysis aimed to identify the risk factors for postoperative delirium after colorectal cancer surgery.


We selected all articles related to postoperative delirium after colorectal surgery published up to March 2019. Studies using any method for diagnosing delirium were eligible. Ovid-Embase, Ovid-Medline, and the Cochrane library were searched. Two reviewers independently conducted quality assessment and data collection. The risk factors identified in the studies were recorded, and a meta-analysis was conducted.


Of the 1216 studies initially screened, 1197 were reviewed by two independent reviewers. Finally, 14 articles were identified to be relevant for this review. In total, 11 of the 14 studies reported the risk factors for postoperative delirium. The incidence of postoperative delirium ranged from 8% to 54%. A total of 19 risk factors were identified, and we classified them into two categories as patient-related and treatment-related risk factors.


Postoperative delirium is highly common in those undergoing colorectal surgery including cancer, with advanced old age, history of preoperative delirium and preoperative serum albumin level which are risk factors for POD. Larger multi-institutional randomized studies to address this issue are warranted in the future.

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This work was supported by the Gachon University research fund of 2019 (grant number GCU-2019-0321). In addition, this research was supported by the Hallym University Research Fund (HURF-2015-03).

Author information

Conception and design: Lim SW, Lee SH.

Acquisition of data, analysis, and interpretation of data: Lee SH.

Drafting of article and critical revision for important intellectual content: Lee SH, Lim SW.

Final approval of the submitted version: Lee SH, Lim SW.

Correspondence to Sang Woo Lim.

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We, the authors, Drs. Lee Seon Heui and Lim Sang Woo, have complied with all applicable ethical standards.

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Lee, S.H., Lim, S.W. Risk factors for postoperative delirium after colorectal surgery: a systematic review and meta-analysis. Int J Colorectal Dis 35, 433–444 (2020). https://doi.org/10.1007/s00384-019-03498-6

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  • Postoperative delirium
  • Risk factor
  • Colorectal surgery