苏醒性谵妄（ED）是指在全身麻醉或镇静苏醒期间或苏醒后立即发生的谵妄。目前缺乏有效的治疗 ED 的药物治疗方法，因此应采取预防措施以尽量减少 ED 的风险。然而，成人 ED 的危险因素尚不清楚。在这项系统评价和荟萃分析中，我们评估了成人 ED 危险因素的证据。在 PubMed、Scopus、Cochrane 图书馆、Google Scholar 和 Embase 数据库中搜索了报告从开始到 2023 年 7 月 31 日期间成人 ED 风险因素的观察性研究。这项荟萃分析纳入了 20 项观察性研究，报告了 19,171 名参与者。术前确定为 ED 危险因素的因素包括年龄<40 岁或≥65 岁、男性、吸烟史、药物滥用、认知障碍、焦虑以及美国麻醉医师协会身体状况评分 III 或 IV。 ED 的术中危险因素包括使用苯二氮卓类药物、吸入麻醉剂或依托咪酯，以及手术因素，包括腹部手术、针对脑肿瘤的额部开颅手术（与其他开颅手术方法相比）以及手术时间。术后危险因素包括留置导尿管、麻醉后监护病房或重症监护病房中存在气管导管、存在鼻胃管和疼痛。了解这些危险因素可以指导对ED高危患者实施分层管理和及时干预。本次综述中纳入的大多数研究仅调查了过度活跃的 ED，需要进一步研究以确定低活跃和混合 ED 类型的危险因素。版权所有 © 2023 作者。由 Wolters Kluwer Health, Inc. 出版

Emergence delirium (ED) is delirium that occurs during or immediately after emergence from general anesthesia or sedation. Effective pharmacological treatments for ED are lacking, so preventive measures should be taken to minimize the risk of ED. However, the risk factors for ED in adults are unclear. In this systematic review and meta-analysis, we evaluated the evidence for risk factors for ED in adults. The PubMed, Scopus, Cochrane Library, Google Scholar, and Embase databases were searched for observational studies reporting the risk factors for ED in adults from inception to July 31, 2023. Twenty observational studies reporting 19,171 participants were included in this meta-analysis. Among the preoperative factors identified as risk factors for ED were age <40 or ≥65 years, male sex, smoking history, substance abuse, cognitive impairment, anxiety, and American Society of Anesthesiologists physical status score III or IV. Intraoperative risk factors for ED were the use of benzodiazepines, inhalational anesthetics, or etomidate, and surgical factors including abdominal surgery, frontal craniotomy (vs. other craniotomy approaches) for cerebral tumors, and the length of surgery. Postoperative risk factors were indwelling urinary catheters, the presence of a tracheal tube in the postanesthetic care unit or intensive care unit, the presence of a nasogastric tube, and pain. Knowledge of these risk factors may guide the implementation of stratified management and timely interventions for patients at high risk of ED. The majority of studies included in this review investigated only hyperactive ED and further research is required to determine risk factors for hypoactive and mixed ED types.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.