title: The incidence of delirium after cardiac surgery in the elderly: protocol for a systematic review and meta-analysis.
abstract: Delirium is one of the most common complications after cardiac surgery in the elderly. Future studies aimed at preventing postoperative delirium will need an accurate estimate of incidence. However, there are no available systematic reviews on the incidence, and reports of incidence of postoperative delirium after a cardiac operation vary widely with significant heterogeneity. Therefore, we aim to perform a systematic review and meta-analysis to determine the most accurate incidence possible of postoperative delirium in individuals aged >65 years after cardiac surgery.
  
  
  
  We will undertake a comprehensive literature search among PubMed, EMBASE, the Cochrane Library, PsycINFO and CINAHL, from their inception to January 2017. Prospective cohort and cross sectional studies that described the incidence of delirium will be eligible for inclusion. The primary outcome will be the incidence of delirium. Risk of bias and methodological quality for the included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence data will be pooled by selective or emergency surgery. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
  
  
  
  This proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence of postoperative delirium among the older population after cardiac surgery, which is necessary for future research in this area. The findings of this study will be presented at conferences and disseminated through publication in a peer reviewed journal.
  
  
  
  CRD42016047773.
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Liao
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Saint Louis University, St Louis, Missouri, USA.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Flaherty
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, The National Center for Geriatric Clinical Research in West China Hospital, Chengdu, Sichuan, China.
authors.forename: Jirong
authors.initials: J
authors.lastname: Yue
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Chuanyao
authors.initials: C
authors.lastname: Deng
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003693:Delirium / Q000209:etiology*; D004812:Epidemiologic Methods; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
keywords: delirium; elderly; incidence; protocol; systematic review and meta-analysis