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心脏手术后成年患者谵妄预防的药物干预:系统评价和网状Meta分析方案

Pharmacologic interventions for preventing delirium in adult patients after cardiac surgery: Protocol of a systematic review and network meta-analysis.

作者信息

Wen Junru, Zeng Hai, Li Zunjiang, He Guoxin, Jin Yueling

机构信息

Shanghai University of Traditional Chinese Medicine, Shanghai.

Shanghai University of Medicine & Health Sciences, Shanghai.

出版信息

Medicine (Baltimore). 2018 Dec;97(52):e13881. doi: 10.1097/MD.0000000000013881.

Abstract

BACKGROUND

Delirium is common in adult patients undergoing cardiac surgery and related to a high morbidity and mortality. Although a variety of pharmacologic interventions have been applied in delirium prevention, there is still uncertainty concerning which drug is optimal. Thus, we plan to conduct a systematic review and network meta-analysis (NMA) of published studies to assess the efficacy and safety of pharmacologic interventions for preventing delirium among those patients.

METHODS

A systematic literature search will be conducted in Embase, PubMed, and the Cochrane Library. The primary outcome will be the incidence of postoperative delirium. Secondary outcomes will include all-cause mortality and length of hospital or intensive care unit stay. A frequentist NMA will be conducted using Stata version 14.0. The inconsistency between direct and indirect comparisons will be evaluated using a node splitting method. In addition, surface under the cumulative ranking area will be used to evaluate superiority of different treatments.

RESULTS

The findings of our review will be submitted to a peer-reviewed publication.

CONCLUSION

Our study will generate convincing evidence regarding the effectiveness and safety of different pharmacologic interventions for delirium prevention in cardiac surgery patients.

摘要

背景

谵妄在接受心脏手术的成年患者中很常见,且与高发病率和死亡率相关。尽管多种药物干预措施已应用于谵妄预防,但对于哪种药物最为理想仍存在不确定性。因此,我们计划对已发表的研究进行系统评价和网状荟萃分析(NMA),以评估药物干预措施对预防这些患者谵妄的疗效和安全性。

方法

将在Embase、PubMed和Cochrane图书馆进行系统的文献检索。主要结局将是术后谵妄的发生率。次要结局将包括全因死亡率以及住院或重症监护病房的住院时间。将使用Stata 14.0版本进行频率论者的NMA。将使用节点拆分方法评估直接和间接比较之间的不一致性。此外,累积排序曲线下面积将用于评估不同治疗的优越性。

结果

我们综述的结果将提交给同行评审的出版物。

结论

我们的研究将为不同药物干预措施预防心脏手术患者谵妄的有效性和安全性提供令人信服的证据。

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