Department of General Medicine, Emergency General Hospital, XiBaHe South Road 29, Chaoyang District, Beijing, 100028, PR China.
Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, China.
BMC Pharmacol Toxicol. 2024 Nov 25;25(1):90. doi: 10.1186/s40360-024-00816-9.
Melatonin has been demonstrated to exert a preventive effect on delirium. This meta-analysis sought to investigate the preventive effects of melatonin and melatonin receptor agonists (ramelteon) on delirium in hospitalized elderly patients.
This systematic review and meta-analysis delineates the risk of delirium events in older hospitalized patients with melatonin/ramelteon compared with placebo, incorporating randomized controlled trials published up to 8 July 2024. The databases searched were PubMed, Embase and the Cochrane Library. The primary outcome measures were the incidence of delirium, while the secondary outcome measures were the length of hospital stay and mortality. The results are presented as odds ratios (OR) or mean differences (MD) with a 95% confidence interval. The review of publications was conducted in accordance with the guidelines set forth in the Cochrane Handbook and the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA). This study has been registered with INPLASY (number INPLASY202470044).
A total of 2086 patients were included in 13 randomized controlled trials. The primary outcome of this meta-analysis demonstrated a statistically difference in the incidence of delirium between the melatonin and placebo groups in hospitalized elderly patients (OR = 0.59, 95% CI: 0.40-0.87, P < 0.01, I = 60%), particularly in those who had undergone surgery (OR = 0.60, 95%CI: 0.40-0.89, P = 0.01, I = 53%). No statistically differences were observed in terms of length of stay (MD=-0.07, 95%CI:-1.09-0.94, P = 0.89, I = 72%) and mortality (OR = 0.79, 95%CI:0.58-1.06, P = 0.12, I = 0%).
Melatonin has been demonstrated to exert a protective effect on delirium in elderly patients who are hospitalized, particularly in the context of perioperative care.
褪黑素已被证明对谵妄具有预防作用。本荟萃分析旨在研究褪黑素和褪黑素受体激动剂（雷美替胺）对住院老年患者谵妄的预防作用。
本系统评价和荟萃分析描述了与安慰剂相比，褪黑素/雷美替胺对住院老年患者谵妄事件风险的影响，纳入了截至 2024 年 7 月 8 日发表的随机对照试验。检索的数据库包括 PubMed、Embase 和 Cochrane 图书馆。主要结局指标为谵妄发生率，次要结局指标为住院时间和死亡率。结果以比值比（OR）或均数差（MD）及其 95%置信区间表示。文献综述符合 Cochrane 手册和系统评价和荟萃分析的 Preferred Reporting Project（PRISMA）规定的指南。本研究已在 INPLASY（编号 INPLASY202470044）中注册。
共有 2086 名患者纳入 13 项随机对照试验。荟萃分析的主要结局表明，在住院老年患者中，褪黑素组与安慰剂组谵妄发生率存在统计学差异（OR=0.59，95%CI：0.40-0.87，P<0.01，I=60%），尤其是在接受手术的患者中（OR=0.60，95%CI：0.40-0.89，P=0.01，I=53%）。两组在住院时间（MD=-0.07，95%CI：-1.09-0.94，P=0.89，I=72%）和死亡率（OR=0.79，95%CI：0.58-1.06，P=0.12，I=0%）方面无统计学差异。
褪黑素已被证明对住院老年患者的谵妄具有保护作用，特别是在围手术期护理方面。
