Prevention of Postoperative Delirium in Patients Undergoing Elective Surgery Using Multicomponent Interventions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Background and hypothesis: Postoperative delirium (POD) is a common acute cognitive disorder among older adults following elective surgery. It prolongs hospitalization, increases the risk of complications and readmission, and may contribute to long-term cognitive decline, thereby reducing patients' quality of life. Although various preventive strategies have been developed, single interventions often yield limited efficacy. This study systematically evaluates, through meta-analysis, the effectiveness of multicomponent interventions in preventing POD among older adults undergoing elective surgery.
Study design: A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) published through July 2025. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess intervention effects, and pooled analyses were performed using a random-effects model.
Study results: Eleven RCTs comprising 3857 patients undergoing elective surgery were included in the final analysis. Multicomponent interventions significantly reduced POD incidence in older adults (RR: 0.71; 95% CI: 0.59-0.85; p 2 = 18.0%, p = 0.272). Sensitivity analyses supported the robustness of results. Subgroup analyses indicated a greater effect in Eastern populations compared to Western populations (interaction p = 0.045).
Conclusions: Multicomponent interventions are effective in reducing POD incidence in older adults undergoing…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,857 participants or records.
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