Background: The occurrence (incidence or prevalence) of delirium in brain tumors is unknown, yet delirium is associated with increased morbidity and mortality and worse quality of life. We conducted a systematic review and meta-analysis to determine the occurrence of delirium in hospitalized patients with brain tumors.Methods: PubMed, Scopus, and Web of Science were systematically searched for papers from 1 January 1999 to 12 July 2024, including references from texts. Cross-sectional, prospective, and other cohort study designs were included, and individual case reports, case series, editorials, and reviews were excluded. The included papers were scored using a validated sensitivity analysis tool and tested for quality and bias using funnel plots and Egger’s test. We used random effects models for the summary estimates. We performed subgroup analyses by tumor type, tumor location, delirium subtype, and length of stay.Results: Of the 452 studies screened, 27 were included, representing 35,958 patients. The overall occurrence of delirium was 0.17 (95% CI [0.11–0.24]). Delirium occurrence in patients with low-grade gliomas, high-grade gliomas, and brain metastases was 0.10 [0.06–0.16], 0.21 [0.10–0.40], and 0.31 [0.16–0.50], respectively. Compared to the occipital lobe, there was a higher occurrence of delirium for tumors in the frontal (RR 3.08 [1.35–8.22]) and temporal lobes (RR 2.88 [1.22–7.93]). The patients were more likely to have hypoactive (RR 1.61 [1.30; 1.98]) than hyperactive delirium. Delirium was associated with 4.62 additional hospitalized days compared to those without delirium (CI [3.23–6.01]).Discussion: We confirmed high occurrence rates of delirium in patients hospitalized with brain tumors. Patients with brain metastases had a higher occurrence of delirium compared to patients with gliomas, and delirium occurrence rates were higher in patients with frontotemporal tumors. Delirium occurrence rates in the literature are very heterogeneous and point toward a need for tailored assessments in patients with brain tumors.
背景：脑肿瘤患者谵妄的发生率（发病率或患病率）尚不明确，但谵妄与发病率、死亡率升高及生活质量下降相关。本研究通过系统综述与荟萃分析，旨在明确脑肿瘤住院患者谵妄的发生情况。 方法：系统检索PubMed、Scopus及Web of Science数据库中自1999年1月1日至2024年7月12日发表的文献，并追溯纳入文献的参考文献。研究纳入横断面研究、前瞻性研究及其他队列研究设计，排除个案报告、病例系列、社论及综述类文献。采用经过验证的敏感性分析工具对纳入文献进行评分，并通过漏斗图与Egger检验评估研究质量及偏倚风险。汇总估计值采用随机效应模型计算，并按肿瘤类型、肿瘤部位、谵妄亚型及住院时长进行亚组分析。 结果：在筛选的452项研究中，共纳入27项研究，涉及35,958例患者。谵妄总体发生率为0.17（95% CI [0.11–0.24]）。低级别胶质瘤、高级别胶质瘤及脑转移瘤患者的谵妄发生率分别为0.10 [0.06–0.16]、0.21 [0.10–0.40]和0.31 [0.16–0.50]。与枕叶肿瘤相比，额叶（RR 3.08 [1.35–8.22]）与颞叶肿瘤（RR 2.88 [1.22–7.93]）患者的谵妄发生率更高。患者更易出现低活动性谵妄（RR 1.61 [1.30; 1.98]）而非高活动性谵妄。与未发生谵妄的患者相比，谵妄患者的住院时间平均延长4.62天（CI [3.23–6.01]）。 讨论：本研究证实脑肿瘤住院患者谵妄发生率较高。脑转移瘤患者的谵妄发生率高于胶质瘤患者，额颞叶肿瘤患者的谵妄发生率更高。现有文献中谵妄发生率存在显著异质性，提示需对脑肿瘤患者开展个体化评估。
Occurrence Rates of Delirium in Brain Tumor Patients: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家