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Table 3 Associations between preoperative medications and postoperative delirium reported in multivariate analyses of risk factor studies

From: Preoperative medication use and postoperative delirium: a systematic review

Study (First author, publication year)

Preoperative medicines

Other covariates

Number of study participants

Number of patients with medications

OR or RR (95% CI)e

P-value

Chen, 2015 [14]

Hypnotics

Advanced age

Prolonged operative time

Decreased postoperative haemoglobin level

401

42

OR 3.07 (1.05–9.04)

0.041

Galanakis, 2001 [18]

Hypnotics and sedatives

Age

Sex

105

21

OR 2.53 (0.79–8.04)

NS

Benoit, 2005 [8]

Psychoactive medicines

Lower education level

Preoperative depression

102

0.18a (0.4c), 0.5b (0.8c)

OR 6.80d

0.005

Xue, 2016 [20]

Psychoactive medicines

Old age

Pain intensity after surgery

358

64

OR 1.60 (0.65–3.93)

0.306

Duppils, 2000 [29]

Psychopharmacological drugs

Older age

Cognitive impairment

Pre-existing cerebrovascular disorders

225

88

OR 2.92 (1.33–6.39)

0.007

Dai, 2000 [26]

Narcotics and other

psychoactive medicines

Age

Pre-existing cognitive impairment

701

1.0a (0.8c), 1.7b (0.9c)

RR 6.56 (1.53–28.17)

< 0.05

Litaker, 2001 [28]

Narcotics

Previous delirium

Age

Pre-existing cognitive impairment

500

87

OR 2.70 (1.4–5.3)

Sig

Behrends, 2013 [33]

Narcotics

Age

Sex

History of central nervous system disorder

Preoperative cognitive dysfunction

Pain

Blood transfusions

472

333

OR 1.02 (0.61–1.70)

0.940

Tully, 2010 [27]

Anticholinergic, selective serotonin re-uptake inhibitor and tricyclic drug

Major depression

Aortic cross-clamp time

Haemoglobin

158

12

OR 6.17 (1.27–30.12)

0.020

Tan, 2008 USA [32]

‘other’ anticholinergic medications

History of cerebrovascular disease

High medical comorbidity

Increased preoperative creatinine level

Increased preoperative pain level

53

20

RR 2.31 (0.85–6.31)

0.100

Brown, 2016 [19]

Antidepressant

Lower baseline cognition

Higher average baseline pain

More intravenous fluid administered

89

26

OR 4.70 (1.03–21.5)

0.046

Benoit, 2005 [8]

Antihypertensive and antianginals

Lower education level

Preoperative

102

0.8a (0.8c), 0.4b (0.5c)

OR 0.26d

0.016

Van Der Mast, 1999 [40]

Nifedipine

Old age

Low level of albumin

Poor physical condition

High ratio of phenylalanine to the sum of isoleucine, leucine, valine,

tyrosine, and tryptophan

296

53

OR 2.40 (1.0–5.8)

0.047

Jeong, 2016 [15]

DIM

Dementia

Age

Sex

475

200

OR 12.8(2.8–57.7)

< 0.001

  1. CI confidence interval, OR odds ratio, RR relative risk, Sig reported as significant, NS reported as not significant, DIM medications whose adverse events, such as delirium, confusion or hallucination, were reported over 1% by the drug information database Micromedex®
  2. aAverage number of medicines in the non-delirium group; bAverage number of medicines in the delirium group; cStandard deviation; dCI not reported or data not sufficient to calculate; eonly for preoperative medicines