{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:50:34Z","timestamp":1781801434164,"version":"3.54.5"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the risk factors associated with postoperative delirium (POD) in patients receiving routine care in the post-anesthesia care unit (PACU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Relevant literature concerning risk factors for POD in PACU patients was retrieved from CNKI, Wanfang, and VIP databases from inception up to August 2025. Three researchers independently completed literature screening, data extraction, quality evaluation, and evidence grading. Meta-analysis was performed using RevMan 5.3 software, and publication bias was assessed using Begg's test in Stata 18.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 20 case-control studies involving 6,877 patients were included. Meta-analysis showed that risk factors for POD in PACU patients included: gender (OR = 1.17, 95%CI:1.03\u20131.33,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), age (SMD = 2.05, 95%CI:1.52\u20132.57,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), prolonged operation time (SMD = 1.02, 95%CI:0.44\u20131.60,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0006), low BMI (SMD = \u22120.29, 95%CI:\u22120.53\u20130.04,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), prolonged anesthesia time (SMD = 1.58, 95%CI:0.88\u20132.88,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), hypertension (OR = 1.27, 95%CI:1.06\u20131.51,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.009), diabetes mellitus (OR = 1.44, 95%CI:1.01\u20132.06,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04), smoking (OR = 1.38, 95%CI:1.11\u20131.71,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004), decreased hemoglobin level (SMD = \u22121.05, 95%CI: \u22123.97\u20130.12,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04), alcohol consumption (OR = 1.33, 95%CI:1.05\u20131.63,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), increased intraoperative blood loss (SMD = 3.74, 95%CI:1.60\u20135.87,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0006), higher American Society of Anesthesiologists (ASA) physical status classification (OR = 0.66, 95%CI:0.47\u20130.92,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), insufficient use of dexmedetomidine (OR = 0.33, 95%CI:0.23\u20130.52,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), prolonged hospital stay (SMD = 2.01, 95%CI:0.76\u20133.27,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002), low educational level (OR = 1.43, 95%CI:1.03\u20131.98,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03), history of cerebral infarction (OR = 2.31, 95%CI:1.48\u20133.60,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0002), and decreased postoperative albumin level (SMD = \u22121.91, 95%CI: \u22122.76\u20131.07,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple demographic, perioperative, and disease-related factors are associated with the occurrence of POD in PACU patients under routine care. This study provides an evidence-based reference for the early identification and prevention of POD. The clinical value of these risk factors as an intervention still needs to be verified by high-quality prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261341102<\/jats:ext-link>\n                      , identifier: CRD420261341102\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1795963","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:32:41Z","timestamp":1774614761000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A meta-analysis on the factors of postoperative delirium in patients undergoing routine care in the recovery room"],"prefix":"10.3389","volume":"13","author":[{"given":"Fenfen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology (Operating Room), Yantai Affiliated Hospital of Binzhou Medical University","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxuan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Yantai Campus, Binzhou Medical University","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjia","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Yantai Campus, Binzhou Medical University","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Bai","sequence":"additional","affiliation":[{"name":"Operating Room, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Yang","sequence":"additional","affiliation":[{"name":"Post-Anesthesia Care Unit, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Yantai Affiliated Hospital of Binzhou Medical University","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"B1","first-page":"811","article-title":"Investigation on influencing factors of unplanned hypothermia in gynecological patients undergoing general anesthesia in PACU","volume":"18","author":"Wang","year":"2021","journal-title":"Nurs Pract Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3760\/cma.j.issn.0578-1426.2019.02.007","article-title":"PICOS: principle in meta-analysis study design","volume":"24","author":"Li","year":"2016","journal-title":"Chin J Interv Cardiol."},{"key":"B3","first-page":"108","article-title":"Expert consensus on delirium management in critically ill patients","volume":"58","author":"Tang","year":"2019","journal-title":"Chin J Intern Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3969\/j.issn.1004-8812.2016.11.005","article-title":"Diagnostic criteria for neurocognitive disorders in the diagnostic and statistical manual of mental disorders (DSM-5) (draft)","volume":"30","author":"Peng","year":"2011","journal-title":"Chin J Geriatri."},{"key":"B5","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol."},{"key":"B6","first-page":"1350","article-title":"How to convert sample size, median, extreme values or quartiles to mean and standard deviation","volume":"17","author":"Tong","year":"2017","journal-title":"Chin J Evid-Based Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2546","DOI":"10.12114\/j.issn.1007-9572.2024.0380","article-title":"Meta-analysis of risk factors for acute lung injury complicated with severe acute pancreatitis","volume":"28","author":"Guo","year":"2025","journal-title":"Chin. Gen Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"643","DOI":"10.12089\/jca.2025.04.002","article-title":"Prediction model of postoperative delirium in patients undergoing laparoscopic radical resection of colorectal cancer","volume":"41","author":"Tang","year":"2025","journal-title":"J Clin Anesthesiol."},{"key":"B10","first-page":"700","article-title":"Analysis of risk factors for postoperative delirium in elderly patients undergoing spinal surgery","volume":"37","author":"Zhang","year":"2024","journal-title":"China J Orthopaed Traumatol."},{"key":"B11","first-page":"463","article-title":"Analysis of risk factors for delirium after cervical spine surgery in elderly patients","volume":"34","author":"Li HM Li","year":"2024","journal-title":"Chin J Spine Spinal Cord."},{"key":"B12","first-page":"513","article-title":"Analysis of risk factors and prognosis of postoperative delirium in elderly patients with hip fracture","volume":"46","author":"Xie","year":"2024","journal-title":"J Inner Mong Med Univ."},{"key":"B13","first-page":"1377","article-title":"Study on the influencing factors of postoperative delirium in elderly patients with hip fracture treated with fascia iliaca compartment block","volume":"16","author":"Zhang","year":"2024","journal-title":"J Mol Diagn Therapy."},{"key":"B14","first-page":"469","article-title":"Clinical characteristics and risk factors of postoperative delirium in cardiac surgery","volume":"43","author":"Yi","year":"2024","journal-title":"J Cardiopulm Vasc Dis."},{"key":"B15","first-page":"651","article-title":"Predictive value of subjective cognitive decline for postoperative delirium","volume":"37","author":"Sun","year":"2023","journal-title":"Pract Geriatr."},{"key":"B16","first-page":"343","article-title":"Reyila\u00b7A, Zhang H, Liu Y, Wang X. Occurrence and risk factors of postoperative delirium in elderly patients with intracerebral hemorrhage in ICU","volume":"30","author":"Ma","year":"2024","journal-title":"Geriatr Health Care"},{"key":"B17","doi-asserted-by":"publisher","first-page":"879","DOI":"10.13898\/j.cnki.issn.1000-2200.2024.07.009","article-title":"Predictive value of ICU Delirium Prediction Score for delirium in intensive care unit patients","volume":"49","author":"Chen","year":"2024","journal-title":"J Bengbu Med Coll."},{"key":"B18","first-page":"730","article-title":"Construction and verification of a risk prediction model for subsyndromal delirium in patients with advanced lung cancer","volume":"40","author":"Li","year":"2025","journal-title":"J Nurses Train."},{"key":"B19","first-page":"642","article-title":"Analysis of risk factors for delirium after frontotemporal tumor resection","volume":"41","author":"Bai","year":"2025","journal-title":"J Clin Anesthesiol."},{"key":"B20","first-page":"249","article-title":"Risk factors for delirium and agitation during anesthetic recovery in pediatric neurosurgery","volume":"44","author":"Wang","year":"2023","journal-title":"J Capital Med Univ."},{"key":"B21","first-page":"92","article-title":"Current status and influencing factors of delirium in the post-anesthesia care unit of patients undergoing major abdominal surgery","volume":"54","author":"Liu","year":"2025","journal-title":"J Med Res."},{"key":"B22","first-page":"947","article-title":"Application of nursing delirium screening scale in delirium after hip replacement in elderly patients","volume":"40","author":"Yang","year":"2020","journal-title":"J Clin Pathol Res."},{"key":"B23","first-page":"5340","article-title":"Analysis of risk factors for delirium after total knee arthroplasty in the elderly and establishment of a nomogram prediction model","volume":"28","author":"Lin","year":"2024","journal-title":"Chin J Tissue Eng Res."},{"key":"B24","first-page":"4703","article-title":"Influencing factors of delirium in elderly patients with femoral neck fracture undergoing spinal anesthesia in the post-anesthesia care unit","volume":"43","author":"Liu","year":"2023","journal-title":"Chin J Gerontol."},{"key":"B25","first-page":"724","article-title":"Analysis of influencing factors and preventive measures of delirium in the post-anesthesia care unit of elderly orthopedic patients undergoing general anesthesia","volume":"21","author":"Li","year":"2021","journal-title":"Prog Mod Biomed."},{"key":"B26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13741-020-00174-0","article-title":"Perioperative risk factors for recovery room delirium after elective non-cardiovascular surgery under general anaesthesia","volume":"10","author":"Wu","year":"2021","journal-title":"Perioper Med Lond."},{"key":"B27","doi-asserted-by":"publisher","first-page":"210","DOI":"10.56434\/j.arch.esp.urol.20247702.27","article-title":"Influencing factors of delirium during recovery in urological postoperative patients undergoing sevoflurane anaesthesia","volume":"77","author":"He","year":"2024","journal-title":"Arch Esp Urol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/j.acvd.2025.04.053","article-title":"Delirium in the cardiac intensive care unit: determinants and prognosis","volume":"118","author":"Fayssoil","year":"2025","journal-title":"Arch Cardiovasc Dis."},{"key":"B29","first-page":"296","article-title":"Research progress of diagnostic and assessment tools for postoperative delirium","volume":"34","author":"Yin","year":"2020","journal-title":"J China-Japan Friends Hospital."},{"key":"B30","first-page":"441","article-title":"Application of confusion assessment method in early assessment and intervention of delirium in ICU","volume":"32","author":"Shao","year":"2017","journal-title":"J Nurses Train."},{"key":"B31","first-page":"1127","article-title":"Differential diagnosis between delirium and dementia","volume":"39","author":"Li","year":"2020","journal-title":"Chin J Geriatr."},{"key":"B32","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3760\/cma.j.issn.1672-7088.2013.30.006","article-title":"Clinical study on evaluating ICU delirium patients with the Chinese version of the intensive care delirium screening checklist","volume":"29","author":"Yang","year":"2013","journal-title":"Chin J Pract Nurs."},{"key":"B33","first-page":"18","article-title":"Clinical study on evaluating ICU delirium with the simplified Chinese version of the nursing delirium screening scale","volume":"30","author":"Ning","year":"2014","journal-title":"Chin J Pract Nurs."},{"key":"B34","first-page":"948","article-title":"Clinical study on predicting delirium in patients with massive gastrointestinal bleeding by APACHE II score","volume":"15","author":"Yang","year":"2020","journal-title":"China J Emerg Resuscit Disaster Med."},{"key":"B35","first-page":"1036","article-title":"Comparative study on the effect of nursing delirium screening scale and intensive care delirium scale in evaluating delirium in patients after PCI","volume":"29","author":"Kuang","year":"2020","journal-title":"Chin J Behav Med Brain Sci."},{"key":"B36","first-page":"28","article-title":"Development of a new delirium screening scale suitable for elderly inpatients in China","volume":"38","author":"Liu","year":"2024","journal-title":"Pract Geriatr"},{"key":"B37","first-page":"352","article-title":"Development and psychometric properties of the Chinese version of the ultra-brief delirium screening scale","volume":"39","author":"Mei","year":"2025","journal-title":"Pract Geriatr."},{"key":"B38","article-title":"Retrospective study on risk factors for postoperative delirium in elderly patients undergoing spinal surgery","author":"Cui","year":"2019","journal-title":"China J Orthop Traumatol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1213\/ANE.0000000000006893","article-title":"The association of preoperative diabetes with postoperative delirium in older patients undergoing major orthopedic surgery: a prospective matched cohort study","volume":"138","author":"Shang","year":"2024","journal-title":"Anesth Analg."},{"key":"B40","first-page":"367","article-title":"Influence of hypertension on cardiovascular and cerebrovascular events in diabetic patients","volume":"31","author":"An","year":"2022","journal-title":"China Pharmaceut."},{"key":"B41","first-page":"419","article-title":"Construction and verification of a regression model for predicting postoperative delirium in elderly hypertensive patients with hip fracture","volume":"60","author":"Ma","year":"2025","journal-title":"Chin J Med."},{"key":"B42","first-page":"264","article-title":"Analysis of risk factors for postoperative delirium in patients undergoing knee arthroplasty","volume":"33","author":"L\u00fc","year":"2017","journal-title":"J Clin Anesthesiol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1795963\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:32:56Z","timestamp":1774614776000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1795963\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":42,"alternative-id":["10.3389\/fmed.2026.1795963"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1795963","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"article-number":"1795963"}}