A scientometric study of publications on delirium from 2001 to 2020

Global incidence and prevalence of delirium and its risk factors in medically hospitalized older patients: A systematic review and meta-analysis

BACKGROUND

Delirium is a common complication among older medical patients that can lead to undesirable outcomes.

OBJECTIVES

This study systematically investigated the incidence, prevalence, and risk factors of delirium to improve its recognition, prevention, and management in medically hospitalized older patients.

METHODS

The study protocol was registered at PROSPERO on April 29, 2024 (registration number: CRD42024536624). We searched the PubMed, Embase, and ProQuest databases for relevant articles published between database inception and September 25, 2024. We included observational studies reporting the prevalence, incidence, and risk factors of delirium among medically hospitalized older patients. Two independent reviewers extracted the data. A random-effects model was used for data analysis.

RESULTS

A total of 35 studies encompassing 12,097 participants met the inclusion criteria, yielding a 23.6 % pooled prevalence of delirium (95 % confidence interval = 19 % to 29 %) and a 13.5 % pooled incidence of delirium (n = 32, 95 % confidence interval = 11 % to 17 %) among medically hospitalized older patients. Study quality and country were significant moderators for explaining the heterogeneity observed in the prevalence and incidence of delirium, respectively (both P < 0.001). The risk factors of delirium included frailty (odds ratio = 2.05), physical restraints (5.01), prior falls (1.99), severe illness (1.32) (evaluated using the Acute Physiology and Chronic Health Evaluation II), and cognitive impairment (2.61). Older age increased delirium risk, whereas years of education mitigated it (B = 1.69 and 0.92, respectively).

CONCLUSION

Our findings considerably enhance the understanding of the prevalence of delirium and its influencing factors in medically hospitalized older patients. The insights this study provides can enable health-care providers to apply quick and effective assessment tools and can thereby support the implementation of interventions to prevent delirium.

REGISTRATION

The study protocol has been prospectively registered on PROSPERO (registration no. CRD42024536624).

Knowledge mapping of induced membrane technique: a scientometric study from 2004 to 2023

BACKGROUND

The induced membrane technique (IMT) is a two-step procedure used for reconstructing segmental bone defects in the limbs. The osteogenic mechanism after bone grafting using IMT remains unclear, and efforts to modify the original techniques are limited to the investigative phase. Therefore, reviewing existing knowledge and identifying hotspots and new trends in IMT is critical.

METHODS

We retrieved reviews and articles associated with IMT published between 2004 and 2023 from the Web of Science Core Collection (WoSCC). The keywords included induced membrane technique, guided bone regeneration, bone defect reconstruction, bone graft, stem cells, Masquelet technique, management of bone defects, and scaffold. HistCite, VOSviewer, CiteSpace, and R-bibliometrics were used for scientometric analysis.

RESULTS

A total of 1019 publications from 374 academic journals with 33,995 co-cited references by 2,331 institutions from 65 countries or regions were included. China (n = 235) and the United States (n = 215) were the most productive countries, with Shanghai Jiao Tong University producing the most number of publications (n = 18). Journal Injury [co-citations = 1774; impact factor (IF) 2022 = 2.5] published the most manuscripts, while Masquelet AC and Giannoudis PV published literature with a significant influence on IMT, showing more co-citations (n = 727; n = 355). Two preface hotspots of IMT focused on investigating the microscopic mechanism (such as the membrane supporting graft-to-bone union and the role of inflammatory cells) and developing new techniques to improve IMT (such as bone tissue engineering and new drugs).

CONCLUSION

This study comprehensively reviewed the literature about IMT published in the last 20 years using qualitative and quantitative methods, providing valuable information for researchers investigating IMT.

The impact of frailty as a critical mediator causing postoperative neurocognitive disorders in postoperative cardiac patients

Frailty is prevalent in elderly cardiac patients and may be a critical predictor of post-operative neurocognitive disorders (PND). The aim of this review was to demonstrate the correlation of frailty with PND in postsurgical elder patients. A review of published literature and bibliometric analysis was undertaken. Electronic databases from 2009 to 2022 were searched to identify articles that evaluated the relationship between frailty and PND in aging populations. Demographic data, type of surgery performed, frailty measurement, and impact of frailty on PND were extracted from the selected studies. The quality of the studies and risk of bias were assessed by the Newcastle-Ottawa Quality Assessment Scale, and the included articles were assessed as medium to high quality. Eighty-one studies were selected for the Bibliometric review in terms of research trends and hotpots. Additionally, 35 observational studies (prospective and retrospective cohorts) were selected for this review. The mean age ranged from 63 to 84 years and included patients undergoing cardiac, orthopedic, and other surgeries who had cardiac symptoms. Regardless of how frailty was measured, the strongest evidence in terms of numbers of studies, consistency of results, and study quality was for associations between frailty and PND. This analysis found a steadily growing focus on frailty and PND research in cardiac and other patients. The observational studies account for the majority of this area, and frailty occurred in the older cardiac patients over 60 years of age, and pre-screening of frailty can be predictive of PND and mortality.

Knowledge mapping and research trends on perioperative neurocognitive disorder from 1990 to 2022: a bibliometric analysis

Introduction

Perioperative neurocognitive disorder (PND) has attracted consistently increasing attention worldwide. However, there are few bibliometric studies that systematically evaluate this field. This study aimed to visualize the knowledge structure and research trends in PND through bibliometrics to help understand the future development of basic and clinical research.

Methods

Literature related to PND in Web of Science and PubMed from 1990 to 2022 were collected through keywords retrospectively. Additionally, the source information, citation information, etc. of these publications were extracted. Finally, bibliometric analysis was performed by visualization software and statistical software.

Results

There were 2837 articles and reviews in total. An exponential rise in PND-related publications was observed. China had the most publication, followed by the US and Germany. The institution with the most output and citations was Harvard University (149 papers, 8966 citations). The most prominent author was Marcantonio Edward R with 66 publications and 5721 citations. The journal with the highest productivity for PND research was Frontiers in Aging Neuroscience followed by Anesthesia and Analgesia. Keywords were identified as six topics, including postoperative delirium, postoperative neurocognitive disorder, cardiac surgery, anaesthesia, orthopedic surgery, and dementia. According to keyword analysis, the most recent popular keywords in PND research were prevention, older patients, emergence delirium, orthopedic surgery, and dexmedetomidine.

Conclusions

Publications on PND are increasing at an alarming rate from 1990 to 2022. Current research and future trends will concentrate on the prevention and treatment of PND, as well as PND associated with orthopedic surgery in older adults.

Evaluation of research trends in the incidence of postoperative neurocognitive disorders in patients undergoing cardiac surgery

Postoperative neurocognitive disorders (PNDs) are a kind of acute central nervous system syndrome, which is a common postoperative complication in cardiac elderly patients. The two most commonly used terms for PNDs are postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). POD often leads to a series of adverse clinical outcomes and even death, so its prevention and treatment has become an important part of perioperative management in elderly patients. In the past decades, research has focused on the mechanism and progress of the pathogenesis of PNDs. Nonetheless, little research has been conducted on the research trends in the relevant field.

Analysis of citation trends to identify articles on delirium worth reading using DDPP model with temporal heatmaps (THM): A bibliometric analysis

BACKGROUND

Delirium is one of the most common geriatric syndromes in older patients, accounting for 25% of hospitalized older patients, 31 to 35% of patients in the intensive care unit, and 8% to 17% of older patients in the emergency department (ED). A number of articles have been published in the literature regarding delirium. However, it is unclear about article citations evolving in the field. This study proposed a temporal heatmap (THM) that can be applied to all bibliographical studies for a better understanding of cited articles worth reading.

METHODS

As of November 25, 2022, 11,668 abstracts published on delirium since 2013 were retrieved from the Web of Science core collection. Research achievements were measured using the CJAL score. Social network analysis was applied to examine clusters of keywords associated with core concepts of research. A THM was proposed to detect articles worth reading based on recent citations that are increasing. The 100 top-cited articles related to delirium were displayed on an impact beam plot (IBP).

RESULTS

The results indicate that the US (12474), Vanderbilt University (US) (634), Anesthesiology (2168), and Alessandro Morandi (Italy) (116) had the highest CJAL scores in countries, institutes, departments, and authors, respectively. Articles worthy of reading were highlighted on a THM and an IBP when an increasing trend of citations over the last 4 years was observed.

CONCLUSION

The THM and IBP were proposed to highlight articles worth reading, and we recommend that more future bibliographical studies utilize the 2 visualizations and not restrict them solely to delirium-related articles in the future.

Bibliometric Analysis of 100 Most-Cited Articles in Delirium

Delirium is a cognitive disorder with complex etiology, which brings a great burden to social health care. Articles with high citation frequency can provide important information about the current research situation in a certain field. Web of Science was used to search the 100 most-cited articles and we extracted key information, such as the authors, countries/regions, institutions, journals, and study types of these articles. CiteSpace was used to visually analyze the keywords. Our bibliometric analysis shows that the attention in this field continues to rise. Authors from the United States published the most articles and Inouye SK is the most influential author in the field. The journals that published these articles have high impact factors. Cohort studies are the main cited articles in this field, and there are a large number of systematic reviews or meta-analyses of cohort studies. Risk factors for delirium, psychometric evaluation, hospital care, and various clinical study design are still the focus of research. In short, we summarized the 100 most-cited articles in the field of delirium to identify the current status and global trends. These results enable researchers to understand the quality and trend of research in the field of delirium and make better use of the classical literature.