{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:20:59Z","timestamp":1786544459653,"version":"build-2736575974"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Delirium is a brain dysfunction syndrome, which children have a higher incidence. At present, there have been more and more studies and reports on delirium in paediatric intensive care unit, but there are some differences in the risk factor results among different studies. To better manage delirium, this study was performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To integrate and clarify the risk factors for delirium in paediatric intensive care unit.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>CNKI, CBMdisc, Wanfang Data Knowledge Service Platform, VIP, PubMed, Embase, Cochrane Library, JBI and PsycInfo were searched for relevant literature. The study subjects were patients in PICU and literature was included according to the PICOS principle. Literature screening and risk of bias assessment were mainly completed by two researchers, and RevMan 5.3 software and Stata software were used for data analysis. The GRADE systerm was used to assess the quality of evidence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 10 studies were included, all in English, involving 4343 children. Within the GRADE system, 4 indicators were scored A, 1 indicators were scored B, and 3 indicators were scored C regarding evidence levels. Three studies analysed the influence of developmental delay on the occurrence of delirium in PICU, total sample size of which was 1823, and the results showed that the combined effect was statistically significant [OR = 3.34, 95%CI(2.46\u20134.53), Z = 7.75, P&lt;0.001]; Five studies analysed the effects of mechanical ventilation on the occurrence of delirium in PICU, sample size of which was 1562, and the results showed that the combined effect was statistically significant [OR = 4.11, 95%CI(3.13\u20135.40), Z = 10.16, P&lt;0.001]; Two studies analysed the effects of benzodiazepines on children developing delirium, sample size of which was 1635, and the results showed that the combined effect was statistically significant [OR = 5.05, 95%CI(3.65\u20136.97), Z = 9.83, P&lt;0.001]; Two studies analysed the effects of anticholinergic drug use on children developing delirium in PICU, sample size of which was 1703, and the results suggested the combined effect was statistically significant [OR = 5.04, 95%CI (3.62\u20137.00), Z = 9.63, P&lt;0.001]; Two studies compared the same age period, sample size of which was 1724 and the results showed that children 2\u20135 years old has a 48% incidence rate of delirium relative to children younger than 2 years old, and the combined effect was statistically significant [OR = 0.48, 95%CI(0.25\u20130.92), Z = 2.22, P = 0.030], children 5\u201313 years old has a 39% incidence rate of delirium relative to children younger than 2 years old, and the combined effect was statistically significant [OR = 0.39, 95%CI(0.26\u20130.59), Z = 4.43, P&lt;0.001]. Two studies analysed the effects of PICU LOS on children developing delirium and the combined effect of PICU LOS on the occurrence of delirium in children in PICU was statistically significant [OR = 1.10, 95%CI(1.05\u20131.15), Z = 4.07, <jats:italic>P<\/jats:italic>&lt;0.001].<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Developmental delay, mechanical ventilation, benzodiazepine use, anticholinergic use, age and PICU length of stay are independent risk factors for delirium in children in PICU. However, only a few articles were included in this study, which may lead to a certain bias and affect the analysing results. More large-sample, multicentre studies should be conducted to further explore and clarify the independent influencing factors of delirium in children in PICU and to provide guidance for clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270639","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T18:06:48Z","timestamp":1657303608000},"page":"e0270639","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":32,"title":["Risk factors of delirium in paediatric intensive care units: A meta-analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5090-0301","authenticated-orcid":true,"given":"Xuelian","family":"ZHU","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3587-3111","authenticated-orcid":true,"given":"Xiaoyan","family":"FENG","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"LIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"DING","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"issue":"11","key":"pone.0270639.ref001","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1542\/hpeds.2019-0115","article-title":"A clinical pathway to standardize care of children with delirium in pediatric inpatient settings","volume":"9","author":"GH Silver","year":"2019","journal-title":"Hosp Pediatr"},{"key":"pone.0270639.ref002","unstructured":"NICE. 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Paterson","year":"2021","journal-title":"Aust Crit Care"},{"issue":"6","key":"pone.0270639.ref006","first-page":"1","article-title":"Utilization of Kotter\u2019s stages and statistical process control to implement and sustain delirium screening in PICU","volume":"6","author":"M Kupferschmid","year":"2021","journal-title":"Pediatr Qual Saf"},{"issue":"8","key":"pone.0270639.ref007","first-page":"1238","article-title":"Research progress on management of delirium in children in ICU","volume":"19","author":"WR Wei","year":"2019","journal-title":"Chinese journal of nursing management"},{"issue":"12","key":"pone.0270639.ref008","doi-asserted-by":"crossref","first-page":"e1175","DOI":"10.1097\/CCM.0000000000002004","article-title":"Cost associated with pediatric delirium in the ICU","volume":"44","author":"C Traube","year":"2016","journal-title":"Crit Care Med"},{"key":"pone.0270639.ref009","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and 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