J Korean Crit Care Nurs.  2021 Oct;14(3):141-156. 10.34250/jkccn.2021.14.3.141.

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

• Kang J
• Choi MJ

• KMID: 2521676
• DOI: http://doi.org/10.34250/jkccn.2021.14.3.141

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 meta-analysis, 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 non-pharmacological interventions, multi-component 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 multi-component interventions to prevent delirium in the Korean ICU patients.

Keyword

Delirium, Intensive care unit, Nonpharmacological, Prevention, Meta-analysis; 섬망, 중환자실, 비약물, 예방, 메타분석