Objective:

This systematic review (SM) and meta-analysis (MA) aims to identify predictors of POD in PD patients undergoing DBS surgery

Background:

Deep brain stimulation (DBS) is a valuable treatment for Parkinson's disease (PD), but postoperative delirium (POD) is a common complication. Understanding the risk factors for POD is crucial for optimizing patient selection and developing preventative measure

Design/Methods:

We conducted a comprehensive search of four major databases for cohort studies on POD in patients undergoing DBS for PD, up to June 2024. Two reviewers independently screened studies, assessed the risk of bias using the Newcastle-Ottawa Scale, and extracted data. Meta-analysis was conducted using Review Manager, with heterogeneity assessed by I² and Q p-value. Subgroup and sensitivity analyses were also performed to explore the consistency of findings.

Results:

Eleven studies, involving 1368 patients, were included in this MA. The incidence of POD in PD patients undergoing DBS was 21% [14.6%, 27.4%] We found that Age, mini-mental state examination (MMSE), non-motor symptoms scale (NMSS) were significant predictors (OR= 1.10; 95% Cl 1.06 - 1.15; p<0.00001), (OR=0.85; 95% Cl 0.72 - 1 .00; P=0.05) and (OR=1.01; 95% Cl 1.00 - 1 .02; P=0.04) respectively. Notably, women, UPDRS-III ON, brain atrophy, diabetes, Hamilton anxiety score (HAMA), Operation time, disease duration, BMI, and cerebral infarction were not significant predictors

Conclusions:

This MA suggests that age, cognitive function, and non-motor symptoms are important factors associated with POD patients undergoing DBS surgery. Further research with larger sample sizes and diverse populations is needed to confirm these findings and identify more specific predictors.