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Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials

Overview of attention for article published in Critical Care, March 2013
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  • Good Attention Score compared to outputs of the same age (71st percentile)
  • Above-average Attention Score compared to outputs of the same age and source (57th percentile)

Mentioned by

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4 tweeters

Citations

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99 Dimensions

Readers on

mendeley
174 Mendeley
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1 CiteULike
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Title
Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials
Published in
Critical Care, March 2013
DOI 10.1186/cc12566
Pubmed ID
Abstract

INTRODUCTION: The ideal measures to prevent postoperative delirium remain unestablished. We conducted this systematic review and meta-analysis to clarify the significance of potential interventions. METHODS: The PRISMA statement guidelines were followed. Two researchers searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for articles published in English before August 2012. Additional sources included reference lists from reviews and related articles from 'Google Scholar'. Randomized clinical trials (RCTs) on interventions seeking to prevent postoperative delirium in adult patients were included. Data extraction and methodological quality assessment were performed using predefined data fields and scoring system. Meta-analysis was accomplished for studies that used similar strategies. The primary outcome measure was the incidence of postoperative delirium. We further tested whether interventions effective in preventing postoperative delirium shortened the length of hospital stay. RESULTS: We identified 38 RCTs with interventions ranging from perioperative managements to pharmacological, psychological or multicomponent interventions. Meta-analysis showed dexmedetomidine sedation was associated with less delirium compared to sedation produced by other drugs (two RCTs with 415 patients, pooled risk ratio (RR) = 0.39; 95% confidence interval (CI) = 0.16 to 0.95). Both typical (three RCTs with 965 patients, RR = 0.71; 95% CI = 0.54 to 0.93) and atypical antipsychotics (three RCTs with 627 patients, RR = 0.36; 95% CI = 0.26 to 0.50) decreased delirium occurrence when compared to placebos. Multicomponent interventions (two RCTs with 325 patients, RR = 0.71; 95% CI = 0.58 to 0.86) were effective in preventing delirium. No difference in the incidences of delirium was found between: neuraxial and general anesthesia (four RCTs with 511 patients, RR = 0.99; 95% CI = 0.65 to 1.50); epidural and intravenous analgesia (three RCTs with 167 patients, RR = 0.93; 95% CI = 0.61 to 1.43) or acetylcholinesterase inhibitors and placebo (four RCTs with 242 patients, RR = 0.95; 95% CI = 0.63 to 1.44). Effective prevention of postoperative delirium did not shorten the length of hospital stay (10 RCTs with 1,636 patients, pooled SMD (standard mean difference) = -0.06; 95% CI = -0.16 to 0.04). CONCLUSIONS: The included studies showed great inconsistencies in definition, incidence, severity and duration of postoperative delirium. Meta-analysis supported dexmedetomidine sedation, multicomponent interventions and antipsychotics were useful in preventing postoperative delirium.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 174 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 2 1%
Brazil 2 1%
United States 2 1%
Italy 1 <1%
Denmark 1 <1%
Korea, Republic of 1 <1%
Japan 1 <1%
Czechia 1 <1%
Unknown 163 94%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 16%
Other 24 14%
Student > Doctoral Student 18 10%
Student > Ph. D. Student 18 10%
Student > Postgraduate 16 9%
Other 62 36%
Unknown 8 5%
Readers by discipline Count As %
Medicine and Dentistry 113 65%
Nursing and Health Professions 17 10%
Psychology 5 3%
Agricultural and Biological Sciences 4 2%
Social Sciences 3 2%
Other 13 7%
Unknown 19 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2014.
All research outputs
#3,735,132
of 13,183,279 outputs
Outputs from Critical Care
#2,456
of 4,240 outputs
Outputs of similar age
#41,085
of 146,182 outputs
Outputs of similar age from Critical Care
#61
of 144 outputs
Altmetric has tracked 13,183,279 research outputs across all sources so far. This one has received more attention than most of these and is in the 71st percentile.
So far Altmetric has tracked 4,240 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.5. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 146,182 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 144 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.