Cochrane · systematic review · CD005563
Interventions for preventing delirium in hospitalised non‐ICU patients
Siddiqi, N, Harrison, JK, Clegg, A, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Dementia and Cognitive ImprovementAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
31
current version
GRADE rated
21
No studies
10
Included studies
NR
No studies 10 · 32.3%Ungraded 0 · 0%Very low 7 · 22.6%Low 6 · 19.4%Moderate 8 · 25.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
A multi‐component delirium prevention intervention compared to usual care for hospitalised non‐ICU patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of delirium validated instruments1 A multi‐component delirium prevention intervention vs usual care | RR 0.69 [0.59, 0.81] | 7 studies · 1950 participants | Moderate Downgraded: risk of bias |
Duration of delirium (days) A multi‐component delirium prevention intervention vs usual care | no estimate extracted | 4 studies · 244 participants | Very low Downgraded: risk of bias |
Severity of delirium DRS‐R‐98 and CAM‐S10 A multi‐component delirium prevention intervention vs usual care | no estimate extracted | 2 studies · 67 participants | Low Downgraded: risk of bias |
Length of admission Days A multi‐component delirium prevention intervention vs usual care | no estimate extracted | 6 studies · 1920 participants | Moderate Downgraded: risk of bias |
Return to independent living A multi‐component delirium prevention intervention vs usual care | RR 0.95 [0.85, 1.06] | 4 studies · 1116 participants | Moderate Downgraded: risk of bias |
Inpatient mortality A multi‐component delirium prevention intervention vs usual care | RR 0.9 [0.56, 1.43] | 3 studies · 859 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Prophylactic cholinesterase inhibitor versus placebo for preventing delirium in hospitalised non‐ICU patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of delirium DSM‐IV criteria, DSI, CAM, Prophylactic cholinesterase inhibitor vs placebo | RR 0.68 [0.17, 2.62] | 2 studies · 113 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Duration of delirium ‐ not measured Prophylactic cholinesterase inhibitor vs placebo | no estimate extracted | NR | No studies |
Severity of delirium MDAS Prophylactic cholinesterase inhibitor vs placebo | no estimate extracted | 1 study · 16 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of admission Days Prophylactic cholinesterase inhibitor vs placebo | no estimate extracted | 3 studies · 128 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Return to independent living ‐ not measured Prophylactic cholinesterase inhibitor vs placebo | no estimate extracted | NR | No studies |
Inpatient mortality ‐ not measured Prophylactic cholinesterase inhibitor vs placebo | no estimate extracted | NR | No studies |
Prophylactic antipsychotic medications for preventing delirium in hospitalised non‐ICU patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of delirium CAM/NEECHAM | RR 0.55 [0.23, 1.3] | 3 studies · 916 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Duration of delirium Days | no estimate extracted | 2 studies · 178 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Severity of delirium DRS. Scale from: 0 to 46. | no estimate extracted | 2 studies · 178 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Length of admission Days | no estimate extracted | 1 study · 68 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Return to independent living ‐ not measured | no estimate extracted | NR | No studies |
Inpatient mortality ‐ not measured | no estimate extracted | NR | No studies |
Prophylactic melatonin for preventing delirium in hospitalised non‐ICU patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of delirium CAM/DSM IV/DRS‐R‐9s | RR 0.53 [0.09, 3.25] | 3 studies · 529 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Duration of delirium Days | no estimate extracted | 1 study · 104 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Severity of delirium (binary severe vs. not severe) Number of patients requiring greater than 3mg of haloperidol | RR 0.86 [0.58, 1.27] | 1 study · 104 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Severity of delirium DRS‐R‐98 score | no estimate extracted | 1 study · 6 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Length of admission Days | no estimate extracted | 2 studies · 500 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Return to independent living ‐ not measured | no estimate extracted | NR | No studies |
In‐hospital mortality Mortality | RR 0.84 [0.37, 1.88] | 3 studies · 543 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Bispectral index (BIS)‐guided anaesthesia versus BIS‐blinded anaesthesia/clinical judgement for preventing delirium in hospitalised non‐ICU patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of delirium CAM, DSM‐IV Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | RR 0.71 [0.6, 0.85] | 2 studies · 2057 participants | Moderate Downgraded: risk of bias |
Duration of delirium ‐ not measured Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | no estimate extracted | NR | No studies |
Severity of delirium ‐ not measured Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | no estimate extracted | NR | No studies |
Length of admission Days Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | no estimate extracted | 2 studies · 2057 participants | Moderate Downgraded: risk of bias |
Return to independent living ‐ not measured Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | no estimate extracted | NR | No studies |
In‐hospital mortality ‐ not measured Bispectral index (BIS)‐guided anaesthesia vs BIS‐blinded anaesthesia/clinical judgement | no estimate extracted | NR | No studies |