Are treatment effects consistent with hypothesized mechanisms of action proposed for postoperative delirium interventions? Reanalysis of systematic reviews
- Resource Type
- Authors
- Daniel Hind; Yuhaniz Malik; Min Hyung Lee; Matthew Lee; Emily G Boxell; Iain J McCullagh; Matthew Wilson; Hannah M Berntsson; Richard S Bourne; Jeyinn Wong
- Source
- Boxell, EG, Malik, Y, Wong, J, Lee, MJ, Berntsson, HM, Lee, MJ, Bourne, RS, McCullagh, IJ, Hind, D & Wilson, MJ 2021, ' Are treatment effects consistent with hypothesized mechanisms of action proposed for postoperative delirium interventions? Reanalysis of systematic reviews. ', Journal of Comparative Effectiveness Research, vol. 10, no. 17, pp. 1301-1315 . https://doi.org/10.2217/cer-2021-0161
- Subject
- medicine.medical_specialty
Psychological intervention
aging health
law.invention
surgery
Postoperative Complications
Randomized controlled trial
law
Humans
Medicine
Dalton Nuclear Institute
Postoperative delirium
Intensive care medicine
business.industry
Mechanism (biology)
Health Policy
Delirium
methodology
meta-analysis
ResearchInstitutes_Networks_Beacons/dalton_nuclear_institute
Systematic review
Action (philosophy)
Meta-analysis
Postoperative inflammation
business
Systematic Reviews as Topic
- Language
- ISSN
- 2042-6313
2042-6305
Aim: Postoperative delirium (POD) is associated with increased morbidity and is poorly understood. The aim of this review was to identify putative mechanisms through re-analysis of randomized trials on treatment or prevention of POD. Materials & methods: A systematic review was performed to identify systematic reviews of treatments for POD. Constituent randomized controlled trials were identified, and interventions were grouped according to hypothesized mechanisms of action. Effects were meta-analyzed by hypothesized mechanism and timing of intervention. Results: A total of 116 randomized controlled trials described 47 individual interventions for POD, with nine mechanisms identified. The largest effects were observed for postoperative inflammation reduction, and preoperative reinforcement of sleep–wake cycle. Conclusion: This approach identifies treatments focused on mechanisms of action that may be front runners for future trials and interventions.