Abstract：
Postoperative delirium (POD) after cancer surgeries can be a result of chemo brain, anesthesia, surgery duration, and preoperative cognitive impairment. Although older age and preoperative cognitive dysfunction were reported to increase the risk of POD in noncardiac surgery, the role of preoperative cognitive function and age in the development of POD after all types of cancer surgeries is not clear. This study aimed to determine the relationship between preoperative cognitive function and likelihood of POD after cancer surgeries. This study used three main online databases and followed PRISMA guidelines. English language original articles that examined preoperative cognitive function before solid tumor cancer surgery and assessed patients for postoperative delirium were included. We employed the random effect meta-analysis method. The overall incidence of POD ranged from 8.7% to 50.9%. The confusion assessment method was the most common tool used to assess delirium. Mini-mental state evaluation (MMSE), Mini-cog, and Montreal cognitive assessment were the most common tools to assess cognitive function. The pooled (total observation = 4676) random effects SMD was estimated at -0.84 (95% confidence interval [CI]: -1.30 to -0.31), indicating that lower MMSE scores before surgery are associated with a higher risk of POD. The pooled (total observation = 2668) random effects OR was estimated at 5.17 (95% CI: 2.51 to -10.63), indicating preoperative cognitive dysfunction can significantly predict the occurrence of POD after cancer surgeries. In conclusion, preoperative cognitive function is an independent and significant predictor of POD after solid tumor cancer surgeries.
摘要：
癌症手术后的术后谵妄（POD）可能是化疗脑的结果，麻醉,手术持续时间,术前认知障碍。尽管据报道，年龄较大和术前认知功能障碍会增加非心脏手术中POD的风险，术前认知功能和年龄在所有类型癌症手术后POD发展中的作用尚不清楚。这项研究旨在确定术前认知功能与癌症手术后POD可能性之间的关系。这项研究使用了三个主要的在线数据库，并遵循了PRISMA指南。包括在实体瘤癌症手术前检查术前认知功能并评估患者术后谵妄的英文原创文章。我们采用随机效应荟萃分析方法。POD的总发生率为8.7%至50.9%。混淆评估方法是评估谵妄最常用的工具。迷你精神状态评估(MMSE)，迷你齿轮,和蒙特利尔认知评估是评估认知功能最常用的工具。汇总（总观察值=4676）随机效应SMD估计为-0.84（95％置信区间[CI]：-1.30至-0.31），表明手术前MMSE评分较低与POD风险较高相关.合并的（总观察值=2668）随机效应OR估计为5.17（95％CI：2.51至-10.63），术前认知功能障碍可显著预测肿瘤术后POD的发生。总之,术前认知功能是实体瘤肿瘤术后POD的独立预测因素。
