Official websites use. Share sensitive information only on official, secure websites. Karin J Neufeld and Jirong Yue contributed equally to this article as co-first authors. Sharon K. Inouye and Dale M. Needham contributed equally to this article as co-senior authors. Prevention and treatment of delirium is critical due to its common occurrence and associated poor outcomes.
Antipsychotic administration for delirium prevention or treatment in randomized controlled trials or cohort studies. Two authors independently reviewed all citations, extracted relevant data and assessed studies for potential bias. Sensitivity analyses included 1 postoperative prevention studies only, 2 exclusion of studies with high risk-of-bias, and 3 typical versus atypical antipsychotics.
Screening of 10, eligible records identified 19 studies. In seven studies comparing antipsychotics to placebo or no treatment for delirium prevention in postoperative patients, there was no significant effect on delirium incidence OR 0. Using data reported from all 19 studies, antipsychotic use was not associated with change in delirium duration, severity, hospital or ICU LOS, with high heterogeneity among studies.
No association with mortality was detected OR 0. Antipsychotics for prevention or treatment of delirium is not supported by current evidence. Additional methodologically rigorous studies using standardized outcome measures are needed. Delirium, a neuropsychiatric syndrome characterized by acute change in arousal and cognition, arising from an underlying medical insult, is associated with poor clinical outcomes, including personal suffering, cognitive decline, institutionalization after hospitalization, increased costs, and increased risk of death.
Participants identified delirium as an essential area in the care of older adults that was the least understood. A panel of experts was formed and a systematic review of the literature was conducted to develop these guidelines.
