Melatonin intervention to prevent delirium in hospitalized patients: A meta-analysis

作者全名："You, Wei; Fan, Xiao-Yu; Lei, Cheng; Nie, Chen-Cong; Chen, Yao; Wang, Xue-Lian"

作者地址："[You, Wei; Chen, Yao; Wang, Xue-Lian] Zigong Fourth Peoples Hosp, Emergency Dept Intens Care Unit, Zigong 643000, Sichuan, Peoples R China; [Fan, Xiao-Yu] Zigong Fourth Peoples Hosp, Dept Gen Surg, Zigong 643000, Sichuan, Peoples R China; [Lei, Cheng] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing 400000, Peoples R China; [Nie, Chen-Cong] Zigong Fourth Peoples Hosp, Dept Nursing, Zigong 643000, Sichuan, Peoples R China; [Fan, Xiao-Yu] Zigong Fourth Peoples Hosp, Dept Gen Surg, 2 Tanmulin St, Zigong 643000, Sichuan, Peoples R China"

通信作者："Fan, XY (通讯作者)，Zigong Fourth Peoples Hosp, Dept Gen Surg, 2 Tanmulin St, Zigong 643000, Sichuan, Peoples R China."

来源：WORLD JOURNAL OF CLINICAL CASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000797318400013

JCR分区：Q3

影响因子：1.1

年份：2022

卷号：10

期号：12

开始页：3773

结束页：3786

文献类型：Article

关键词：Melatonin; Delirium; Prevention; Meta-analysis; Randomized controlled trial

摘要："BACKGROUND & nbsp;Evaluation of the effectiveness of melatonin is necessary to prevent the development of delirium in hospitalized patients. Melatonin (N-acetyl-5-methoxytryptamine) is a hormone produced by the pineal gland of the brain from the amino acid tryptophan. Synthetic melatonin supplements have been used for various medical conditions, especially sleep-related diseases, and have proved to be successful.& nbsp;AIM & nbsp;To determine the effect of melatonin on the prevention of delirium in hospitalized patients.& nbsp;METHODS & nbsp;A literature search of the CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Embase, Cochrane Library, Web of Science, and other databases was conducted. The CNKI, Wanfang Database, VIP Database (VIP), and China Biomedical Literature Database were searched for Chinese studies, and PubMed, Embase, Cochrane Library, Web of Science and other databases were searched for international studies. It will be established in June 2021 in a randomized controlled trial (RCT) whether melatonin treatment for 6 mo prevents delirium in hospitalized patients. Literature screening, quality review, and data extraction were carried out using the Cochrane Manual 5.1.0 systematic evaluation method, and Stata 15.0 software and Review Manager 5.3 were used for meta-analysis and processing.& nbsp;RESULTS & nbsp;A total of 18 new RCT articles and 18 experimental subjects were identified. The results of the meta-analysis showed that following the occurrence of delirium, melatonin reduced the incidence of delirium in patients (RR = 0.69, 95%CI: 0.60-0.80), which is of significance, but heterogeneity was significant I-2 = 62%. Subgroup analysis was performed to examine the source of heterogeneity, and it was found that different patient types were the source of heterogeneity; the research on subgroup analysis was of high quality and homogeneous. To determine the reliability and robustness of the research results, a sensitivity analysis was carried out. The results showed that after excluding individual studies one by one, the effect size was still within 95%CI, which strengthened the reliability of the original meta-analysis results. Melatonin has a significant preventive effect on delirium in hospitalized medical patients [RR = 0.60, 95%CI: 0.47-0.76), P < 0.001].& nbsp;CONCLUSION & nbsp;Melatonin can reduce the rate of delirium in medical patients, and the role of melatonin in reducing the incidence of delirium in surgical patients and critical care unit patients requires further study."

基金机构：Scientific Research Project of Sichuan Provincial Health Commission [19PJ045]

基金资助正文："Supported by the Scientific Research Project of Sichuan Provincial Health Commission, No. 19PJ045."