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Lookup NU author(s): Dr Iain McCullagh
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2021 The Authors.Aim: Postoperative delirium (POD) is associated with increased morbidity and is poorly understood. The aim of this review was to identify putative mechanisms through re-analysis of randomized trials on treatment or prevention of POD. Materials &methods: A systematic review was performed to identify systematic reviews of treatments for POD. Constituent randomized controlled trials were identified, and interventions were grouped according to hypothesized mechanisms of action. Effects were meta-analyzed by hypothesized mechanism and timing of intervention. Results: A total of 116 randomized controlled trials described 47 individual interventions for POD, with nine mechanisms identified. The largest effects were observed for postoperative inflammation reduction, and preoperative reinforcement of sleep-wake cycle. Conclusion: This approach identifies treatments focused on mechanisms of action that may be front runners for future trials and interventions.
Author(s): Boxell EG, Malik Y, Wong J, Lee MH, Berntsson HM, Lee MJ, Bourne RS, McCullagh IJ, Hind D, Wilson MJ
Publication type: Review
Publication status: Published
Journal: Journal of Comparative Effectiveness Research
Year: 2021
Volume: 10
Issue: 17
Pages: 1301-1315
Print publication date: 01/12/2021
Online publication date: 29/09/2021
Acceptance date: 23/08/2021
ISSN (print): 2042-6305
ISSN (electronic): 2042-6313
Publisher: Future Medicine Ltd.
URL: https://doi.org/10.2217/cer-2021-0161
DOI: 10.2217/cer-2021-0161
PubMed id: 34585622
