Evidence map›Paper›PMID 41220459›Full record

ReviewCureus2025

The Impact of Preoperative Hepatic Impairment on the Development of Postoperative Delirium: A Systematic Review and Meta-Analysis.

Will S Roberts, Vaibhav Mittal, Michael N Ryan, Alexander D Knight, Sarah Schaffer, Andrew Clifford, Jean-Pierre P Ouanes

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Will S RobertsOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Vaibhav MittalOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Michael N RyanOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Alexander D KnightOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Sarah SchafferOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Andrew CliffordOsteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA.
Jean-Pierre P OuanesAnesthesiology, Weill Cornell Medicine, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Postoperative delirium (POD) is one of the most common psychiatric and neurologic complications experienced by patients undergoing general anesthesia. While it is widely hypothesized that hepatic impairment is associated with POD, the increased risk that various forms of preoperative hepatic impairment contribute to the development of POD is not well defined in the literature. A database search was performed on Embase, Web of Science, and MEDLINE-PubMed searching for articles containing keywords regarding the association between hepatic impairment and POD, ultimately yielding 34 studies for inclusion. Adjusted odds ratios (ORs) were extracted, with two-sided p-values <0.05 deemed significant. A total of 12,089 patients were included in this review, of which 2,663 developed POD (overall incidence of 22.03%). Inverse variance random-effects meta-analysis reveals that history of alcohol consumption (OR: 2.59, 1.85 - 3.64, p<0.0001), history of hepatic encephalopathy (OR: 3.42, 2.25 - 5.19, p<0.0001), and a MELD (Model for End-Stage Liver Disease) score ≥15 (OR 3.73, 1.93 - 7.20, p<0.0001) are independent risk factors for POD. Elevated serum IL-6 and total bilirubin did not reach significance as risk factors. Based on our findings, a medical history of known hepatic pathology potentially increases a patient's risk for POD. However, our study did not implicate any specific biomarkers as predisposing risk factors for POD but rather their indicated summative hepatic influence in the form of a MELD score.

Indexed as

alcohol consumptionhe: hepatic encephalopathyhepatic impairmentpostoperative deliriumsurgical outcome

Identifiers

PMID41220459
PMCPMC12598256

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Registered trials

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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.