University of Bristol, Bristol, UK.
Bristol Heart Institute, University of Bristol, Bristol, UK.
BMJ Open. 2023 Dec 10;13(12):e076919. doi: 10.1136/bmjopen-2023-076919.
Delirium is a syndrome characterised by a disturbance in attention, awareness and cognition as a result of another physical condition. It occurs in up to 50% of patients after cardiac surgery and is associated with increased mortality, prolonged intensive care and hospital stay and long-term cognitive dysfunction. Identifying effective preventive interventions is important. We will therefore conduct a systematic review to identify all randomised controlled studies that have tested a pharmacological or non-pharmacological intervention to prevent delirium.
We will search electronic databases (CDSR (Reviews), CENTRAL (Trials), MEDLINE Ovid, Embase Ovid, PsycINFO Ovid) as well as trial registers (clinicaltrials.gov and ISCRTN) for randomised controlled trials of both pharmacological and non-pharmacological interventions designed to prevent delirium after cardiac surgery in adults. Screening of search results and data extraction from included articles will be performed by two independent reviewers using Rayyan. The primary outcome will be the incidence of delirium. Secondary outcomes include: duration of postoperative delirium, all-cause mortality, length of postoperative hospital and intensive care stay, postoperative neurological complications other than delirium, health-related quality of life and intervention-specific adverse events. Studies will be assessed for risk of bias using the Cochrane RoB2 tool. A narrative synthesis of all included studies will be presented and meta-analysis (if appropriate network meta-analysis) will be undertaken where there are sufficient studies (three or more) for pooling results. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
No ethical approval is required. This review will be disseminated via peer-reviewed manuscript and conferences.
CRD42022369068.
谵妄是一种以注意力、意识和认知障碍为特征的综合征，是由其他身体状况引起的。它发生在多达 50%的心脏手术后患者中，并与死亡率增加、重症监护和住院时间延长以及长期认知功能障碍有关。确定有效的预防干预措施很重要。因此，我们将进行系统评价，以确定所有已测试药物或非药物干预以预防心脏手术后谵妄的随机对照研究。
我们将搜索电子数据库（CDSR（综述）、CENTRAL（试验）、MEDLINE Ovid、Embase Ovid、PsycINFO Ovid）以及试验登记处（clinicaltrials.gov 和 ISCRTN），以寻找旨在预防成人心脏手术后谵妄的药物和非药物干预的随机对照试验。使用 Rayyan 对搜索结果和纳入文章的数据进行筛选和提取。主要结局将是谵妄的发生率。次要结局包括：术后谵妄持续时间、全因死亡率、术后住院和重症监护停留时间、除谵妄以外的术后神经系统并发症、健康相关生活质量和干预特异性不良事件。将使用 Cochrane RoB2 工具评估研究的偏倚风险。将对所有纳入研究进行叙述性综合，并在有足够数量的研究（三个或更多）进行结果汇总时进行荟萃分析（如果合适，则进行网络荟萃分析）。结果将根据系统评价和荟萃分析的首选报告项目进行报告。
不需要伦理批准。本综述将通过同行评审的手稿和会议进行传播。
PROSPERO 注册号：CRD42022369068。
