Effects of non-pharmacological interventions on post-operative delirium in cardiac surgery patients: a systematic review and network meta-analysis.
Mengting Zeng, Yiheng Zhang, Xiangyue Yu et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and network meta-analysis compared non-pharmacological interventions (NPIs) with routine care for preventing post-operative delirium in cardiac surgery patients. It included 26 randomized controlled trials involving 2,913 participants. Overall, NPIs were associated with lower delirium incidence than routine care (OR = 0.42, 95% CI = 0.34-0.50) and shorter delirium duration (MD = -0.96, 95% CI = -1.06 to -0.86). Network comparisons found significant reductions in incidence with multicomponent therapy and health education; multicomponent therapy showed the most favourable effects overall.
Key findings
- Across interventions, delirium incidence was lower than with routine care (OR = 0.42, 95% CI = 0.34-0.50; I2= 51%).
- Multicomponent therapy reduced delirium incidence (OR = 0.30, 95% CI = 0.19-0.47); health education also reduced incidence (OR = 0.33, 95% CI = 0.12-0.88).
- NPIs shortened delirium duration (MD = -0.96, 95% CI = -1.06 to -0.86; I2 = 0%), with multicomponent therapy showing the greatest reduction.
Why it matters
Post-operative delirium is an important outcome in cardiac surgery, and this synthesis suggests that non-drug approaches may reduce both its occurrence and duration. The comparative findings highlight multicomponent strategies as a promising approach, while also indicating that intervention choice matters. These results can inform consideration of prevention strategies, but should be interpreted in light of the evidence base from the included trials.
What to keep in mind
The review’s estimates derive from 26 trials, and heterogeneity for the overall incidence comparison was moderate (I2= 51%).