A Systematic Review and Meta-analysis on the Effect of Delirium Prevention Intervention in Korean Intensive Care Units

Abstract

Purpose This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods For this systematic review and metaanalysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI: 0.49~0.91, p=.011), but not the duration (SMD=–0.22, 95% CI: −0.51∼0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI: 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI: 0.33∼1.40, p=.295). Among the nonpharmacological interventions, multicomponent intervention had the largest effect size (OR=0.38, 95% CI: 0.26~0.55, p<.001). Conclusion Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multicomponent interventions to prevent delirium in the Korean ICU patients. Key Words: Delirium, Intensive care unit, Nonpharmacological, Prevention, metaanalysis 주요어: 섬망, 중환자실, 비약물, 예방, 메타분석