Castro Viviana, Guinguis Rami, Carrasco Marcela
Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
Proyecto Epistemonikos, Santiago, Chile; Departamento de Medicina Interna- Geriatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email:
Medwave. 2018 Apr 20;18(2):e7196. doi: 10.5867/medwave.2018.02.7195.
Antipsychotics have been proposed as a pharmacological alternative to prevent postoperative delirium. Nonetheless, their actual clinical benefits and harms are a matter of debate.
To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the chosen systematic reviews, reanalyzed the data from the primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
We identified 16 systematic reviews that included eight primary studies, all were randomized trials. We concluded the use of prophylactic antipsychotics reduces the incidence of postoperative delirium, but has no effect on the duration of hospital stay and might increase mortality.
抗精神病药物已被提议作为预防术后谵妄的一种药理学替代方法。尽管如此，其实际的临床益处和危害仍存在争议。
为回答这个问题，我们使用了Epistemonikos，这是健康领域最大的系统评价数据库，通过筛选多个信息来源来维护，包括MEDLINE、EMBASE、Cochrane等。我们从选定的系统评价中提取数据，重新分析了原始研究的数据，进行了荟萃分析，并使用GRADE方法生成了结果总结表。
我们确定了16项系统评价，其中包括8项原始研究，均为随机试验。我们得出结论，使用预防性抗精神病药物可降低术后谵妄的发生率，但对住院时间无影响，且可能增加死亡率。
