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Interventions for preventing delirium in hospitalised non-ICU patients
Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, Simpkins SA.. The Cochrane database of systematic reviews, 2016-03-11
Topic: Risk, prevention and care in population studies
Main results We included 39 trials that recruited 16,082 participants, assessing 22 different interventions or comparisons. Seven studies were conducted in general medical or geriatric medicine settings.We found multi-component interventions reduced the incidence of delirium compared to usual care (RR 0.69, 95% CI 0.59 to 0.81; seven studies; 1950 participants; moderate-quality evidence). In the subgroup of patients with pre-existing dementia, the effect of multi-component interventions remains uncertain (RR 0.90, 95% CI 0.59 to 1.36; one study, 50 participants; low-quality evidence).There is no clear evidence that cholinesterase inhibitors are effective in preventing delirium compared to placebo (RR 0.68, 95% CI, 0.17 to 2.62; two studies, 113 participants; very low-quality evidence).Three trials provide no clear evidence of an effect of antipsychotic medications as a group on the incidence of delirium (RR 0.73, 95% CI, 0.33 to 1.59; 916 participants; very low-quality evidence). However, delirium incidence was lower (RR 0.36, 95% CI 0.24 to 0.52; one study; 400 participants, moderate-quality evidence) for patients treated with an atypical antipsychotic (olanzapine) compared to placebo (moderate-quality evidence).There is no clear evidence that melatonin or melatonin agonists reduce delirium incidence compared to placebo (RR 0.41, 95% CI 0.09 to 1.89; three studies, 529 participants; low-quality evidence).There is moderate-quality evidence that Bispectral Index (BIS)-guided anaesthesia reduces the incidence of delirium compared to BIS-blinded anaesthesia or clinical judgement (RR 0.71, 95% CI 0.60 to 0.85; two studies; 2057 participants).It is not possible to generate robust evidence statements for a range of additional pharmacological and anaesthetic interventions due to small numbers of trials, of variable methodological quality.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Siddiqi, N., Harrison, J. K., Clegg, A., Teale, E. A., Young, J., Taylor, J., et al. (2016). Interventions for preventing delirium in hospitalised non-ICU patients. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd005563.pub3
Vancouver
Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, et al. Interventions for preventing delirium in hospitalised non-ICU patients. The Cochrane database of systematic reviews. 2016. doi:10.1002/14651858.cd005563.pub3. PMID: 26967259.
BibTeX
@article{siddiqi2016-26967259,
author = {Siddiqi, N. and Harrison, J. K. and Clegg, A. and Teale, E. A. and Young, J. and Taylor, J. and Simpkins, S. A.},
title = {{Interventions for preventing delirium in hospitalised non-ICU patients}},
journal = {The Cochrane database of systematic reviews},
year = {2016},
doi = {10.1002/14651858.cd005563.pub3},
pmid = {26967259},
url = {https://doi.org/10.1002/14651858.cd005563.pub3}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Main results We included 39 trials that recruited 16,082 participants, assessing 22 different interventions or comparisons.
- Seven studies were conducted in general medical or geriatric medicine settings.We found multi-component interventions reduced the incidence of delirium compared to usual care (RR 0.69, 95% CI 0.59 to 0.81; seven studies; 1950 participants; moderate-quality evidence).
- In the subgroup of patients with pre-existing dementia, the effect of multi-component interventions remains uncertain (RR 0.90, 95% CI 0.59 to 1.36; one study, 50 participants; low-quality evidence).There is no clear evidence that cholinesterase inhibitors are effective in preventing delirium compared to placebo (RR 0.68, 95% CI, 0.17 to 2.62; two studies, 113 participants; very low-quality evidence).Three trials provide no clear evidence of an effect of antipsychotic medications as a group on the incidence of delirium (RR 0.73, 95% CI, 0.33 to 1.59; 916 participants; very low-quality evidence).
- However, delirium incidence was lower (RR 0.36, 95% CI 0.24 to 0.52; one study; 400 participants, moderate-quality evidence) for patients treated with an atypical antipsychotic (olanzapine) compared to placebo (moderate-quality evidence).There is no clear evidence that melatonin or melatonin agonists reduce delirium incidence compared to placebo (RR 0.41, 95% CI 0.09 to 1.89; three studies, 529 participants; low-quality evidence).There is moderate-quality evidence that Bispectral Index (BIS)-guided anaesthesia reduces the incidence of delirium compared to BIS-blinded anaesthesia or clinical judgement (RR 0.71, 95% CI 0.60 to 0.85; two studies; 2057 participants).It is not possible to generate robust evidence statements for a range of additional pharmacological and anaesthetic interventions due to small numbers of trials, of variable methodological quality.
Why it matters
This review found that multi-component interventions reduced the incidence of delirium in hospitalized non-ICU patients compared with usual care. In the subgroup of patients with pre-existing dementia the effect remained uncertain, and there was no clear evidence that cholinesterase inhibitors, antipsychotics as a group, or melatonin reduced delirium; delirium is not Alzheimer's disease.
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Study details
- Participants39
- Effect sizeRR 0.69; RR 0.63; RR 0.71
- Evidence strengthHigh
How this study scored 77/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. We have no data on senior author's track record, so that was left out: it earned 74 of the 96 points we could judge it on, which is 77 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Cochrane database of systematic reviews) |
| Journal's citation record | 3 / 4 | Cochrane Database of Systematic Reviews: journal h-index 468 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 39 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 6 / 7 | Cited 622 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 51.8 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 6 / 6 | Cited 64.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 3 / 4 | Cited 93 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Samantha A Simpkins holds only 6 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26967259) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 74 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 74 of the 96 points we could judge it on is 77 out of 100. |
| Total | 77 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/14651858.cd005563.pub3
- PubMed: 26967259
- Original source →
- Free full text: Cochrane Database of Systematic Reviews →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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