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The Effect of Treatment of Anemia with Blood Transfusion on Delirium: A Systematic Review

van der Zanden, V., Beishuizen, S. J., Swart, L. M., de Rooij, S. E. & van Munster, B. C., Apr-2017, In : Journal of the American Geriatrics Society. 65, 4, p. 728-737 10 p.

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  • The Effect of Treatment of Anemia with Blood Transfusion on Delirium

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DOI

ObjectivesTreating the precipitating factors of delirium is the mainstay of the prevention and treatment of delirium. We aim to investigate the role of anemia and blood transfusion within the multicomponent prevention and treatment strategy of delirium.

DesignSystematic review.

SettingWe included cohort studies or Randomized Controlled Trials (RCTs) that considered blood transfusion as treatment for delirium or risk factor, and had delirium as outcome.

ParticipantsHospitalized patients above 55 years old.

MeasurementsWe searched MEDLINE from 1946 through November 2014. Quality assessment and data extraction were performed systematically.

ResultsWe included 23 studies (n = 29,471). The majority of the studies (n = 22) had a limited quality and for one study quality was uncertain. Two studies evaluated the association between transfusion strategy and postoperative delirium and found no association. Twenty-one studies investigated blood transfusion as a risk factor for delirium. In four of the 21 studies it could be assumed that delirium occurred after transfusion. One of these studies stated that transfusion was a significant risk factor for subsequent delirium (odds ratio (OR) = 3.68, 95% confidence interval (CI) = 1.32-10.94). The other three studies found no association between transfusion and delirium. In the remaining 17 studies, it was not clear whether delirium occurred before or after transfusion, so no conclusion could be drawn on the role of transfusion in delirium development.

ConclusionThe majority of the included studies was not suited to answer the research question properly as the time course of the beginning of delirium as to transfusion was lacking. Our review shows that there is no good quality evidence available for blood transfusion to be a risk factor for delirium or to be a preventive or treatment option.

Original languageEnglish
Pages (from-to)728-737
Number of pages10
JournalJournal of the American Geriatrics Society
Volume65
Issue number4
Publication statusPublished - Apr-2017

    Keywords

  • delirium, anemia, blood transfusion, elderly, geriatric, INTENSIVE-CARE-UNIT, POSTOPERATIVE DELIRIUM, CARDIAC-SURGERY, RISK-FACTORS, INFLAMMATORY RESPONSE, VASCULAR-SURGERY, CELL TRANSFUSION, HIP FRACTURE, OLDER-ADULTS, PREVENTION

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