Evidence map›Paper›PMID 40011375›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2025

Risk factors for pediatric emergence delirium: a systematic review.

Kazuyoshi Aoyama, Machiko Furuta, Lieven Ameye, Maria-Alexandra Petre, Marina Englesakis, Mehwish Rana, Nan Gai, Arie Peliowski, Bibek Saha

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kazuyoshi AoyamaDepartment of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada. kazu.aoyama@utoronto.ca.ORCID 0000-0002-7502-0896
Machiko FurutaDepartment of Anesthesia and Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan.
Lieven AmeyeDepartment of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
Maria-Alexandra PetreMontreal Children's Hospital, Montreal, QC, Canada.
Marina EnglesakisLibrary and Information Services, University Health Network, Toronto, ON, Canada.
Mehwish RanaUniversity of Toronto, Toronto, ON, Canada.
Nan GaiDepartment of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
Arie PeliowskiDepartment of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
Bibek SahaDepartment of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Funding

Hospital for Sick Children Outcomes Research Award 2020-2021, Department of Anesthesia and Pain MedicineHospital for Sick Children Perioperative Services Summer Studentship Program 2019
6 · The paper itself

Abstract

purposeEmergence delirium (ED) impacts approximately 25% of pediatric patients undergoing general anesthesia and is associated with with concerning consequences, including injury to patients and health care personnel. Risk prediction models with good usability for pediatric ED are lacking. We aimed to identify published risk factors in this systematic review.

methodsWe conducted a systematic literature search of prospective observational studies and clinical trials through eight major databases from inception to 11 January 2023. We included prospective studies published in English that examined the pediatric population (< 18 yr old) undergoing general anesthesia for any surgical or imaging procedure, that measured the risk factor(s) for ED preoperatively/intraoperatively, and that reported the incidence of ED. We excluded studies investigating therapeutic or prophylactic interventions of ED. We assessed the quality of eligible articles according to a modified version of the Scottish Intercollegiate Guidelines Network quality checklists and rated them as high, acceptable, or low quality. Risk factors discovered were qualitatively evaluated and synthesized with the following levels of evidence: strong evidence, moderate evidence, inconclusive evidence, or lack of evidence.

resultsThirty-one studies, comprising a total of 6,068 patients, met the inclusion criteria. The median incidence of ED was 32%. Twelve studies were rated as high quality, 15 as acceptable quality, and the remaining four as low quality. Younger age and agitated/excited induction behaviour with strong evidence, followed by sevoflurane with moderate evidence, were identified as risk factors for pediatric ED. Quantitative synthesis was not feasible as there were no more than two studies that explored the same risk factor with the same cut-off.

conclusionAlthough quantitative analyses were not feasible, the current systematic review qualitatively identified three risk factors for pediatric ED with robust evidence. STUDY REGISTRATION: PROSPERO ( CRD42020192221 ); first submitted 18 June 2020.

Indexed as

Anesthesia, GeneralEmergence DeliriumAdolescentChildHumansIncidenceObservational Studies as TopicProspective StudiesRisk Factorsemergence deliriumgeneral anesthesiapediatric anesthesiarisk factorssystematic review

Identifiers

PMID40011375

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.