褪黑素对预防住院老年患者谵妄的影响:系统回顾和荟萃分析。

IF 2.8 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Le Liu, Xin Ma, Zejun Song, Jie Li, Yasong Zhao, Chang Meng, Shufang Wang, Guobin Miao, Peng Liu
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引用次数: 0

摘要

目的:褪黑素对谵妄有预防作用。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:本系统综述和荟萃分析将截至2024年7月8日发表的随机对照试验纳入其中,与安慰剂相比,本系统综述和荟萃分析划定了老年住院患者使用褪黑素/雷美替胺发生谵妄事件的风险。检索的数据库包括 PubMed、Embase 和 Cochrane Library。主要结果指标为谵妄发生率,次要结果指标为住院时间和死亡率。结果以几率比(OR)或平均差异(MD)表示,并附有 95% 的置信区间。本研究根据《科克伦手册》(Cochrane Handbook)和《系统综述和荟萃分析首选报告项目》(Preferred Reporting Project for Systematic Review and Meta-Analysis,PRISMA)中规定的指南对出版物进行了综述。本研究已在 INPLASY 注册(编号为 INPLASY202470044):结果:13 项随机对照试验共纳入了 2086 名患者。这项荟萃分析的主要结果显示,在住院老年患者中,褪黑素组和安慰剂组的谵妄发生率存在统计学差异(OR = 0.59,95%CI:0.40-0.87,P 2 = 60%),尤其是在接受过手术的患者中(OR = 0.60,95%CI:0.40-0.89,P = 0.01,I2 = 53%)。在住院时间(MD=-0.07,95%CI:-1.09-0.94,P=0.89,I2=72%)和死亡率(OR=0.79,95%CI:0.58-1.06,P=0.12,I2=0%)方面未观察到统计学差异:褪黑素对住院老年患者的谵妄具有保护作用,尤其是在围手术期护理中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of melatonin on the prevention of delirium in hospitalized older patients: systematic review and meta-analysis.

Objectives: 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.

Methods: 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).

Results: 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, I2 = 60%), particularly in those who had undergone surgery (OR = 0.60, 95%CI: 0.40-0.89, P = 0.01, I2 = 53%). No statistically differences were observed in terms of length of stay (MD=-0.07, 95%CI:-1.09-0.94, P = 0.89, I2 = 72%) and mortality (OR = 0.79, 95%CI:0.58-1.06, P = 0.12, I2 = 0%).

Conclusions: Melatonin has been demonstrated to exert a protective effect on delirium in elderly patients who are hospitalized, particularly in the context of perioperative care.

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来源期刊
BMC Pharmacology & Toxicology
BMC Pharmacology & Toxicology PHARMACOLOGY & PHARMACYTOXICOLOGY&nb-TOXICOLOGY
CiteScore
4.80
自引率
0.00%
发文量
87
审稿时长
12 weeks
期刊介绍: BMC Pharmacology and Toxicology is an open access, peer-reviewed journal that considers articles on all aspects of chemically defined therapeutic and toxic agents. The journal welcomes submissions from all fields of experimental and clinical pharmacology including clinical trials and toxicology.
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