Pharmacological and non-pharmacological interventions to prevent delirium after cardiac surgery: a protocol for a systematic review and meta-analysis

Elizabeth Cottuli de Cothi, Rachel Perry, Rahul Kota, Terrie Walker-Smith, Jonathan David Barnes, Maria Pufulete, Ben Gibbison

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

INTRODUCTION: 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.

METHODS AND ANALYSIS: 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.

ETHICS AND DISSEMINATION: No ethical approval is required. This review will be disseminated via peer-reviewed manuscript and conferences.

PROSPERO REGISTRATION NUMBER: CRD42022369068.

Original languageEnglish
Article numbere076919
Pages (from-to)e076919
JournalBMJ Open
Volume13
Issue number12
DOIs
Publication statusPublished - 10 Dec 2023

Bibliographical note

Funding Information:
This study was funded by Bristol and Weston Hospitals Charity. There was no funding number for this study. There was no sponsor for this study. The funder played no part in the design, conduct or reporting of this study.

Publisher Copyright:
© 2023 BMJ. All rights reserved.

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