Effects of Glucocorticoids on Postoperative Delirium in Adult Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis

Clin Ther. 2021 Sep 18:S0149-2918(21)00265-4. doi: 10.1016/j.clinthera.2021.07.021. Online ahead of print.ABSTRACTPURPOSE: Delirium is a common neurologic complication after cardiac surgery and is associated with a poor prognosis. Several studies have explored the effects of glucocorticoids on postoperative delirium (POD). However, conclusion have been inconsistent. The purpose of this systematic review and meta-analysis is to evaluate the effects of glucocorticoids on POD in adult patients undergoing cardiac surgery.METHODS: A systematic literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Library/Central, and Web of Science from inception to January 28, 2021. Randomized controlled trials evaluating the effects of perioperative glucocorticoids administration on the incidence of POD in adults (≥18 years of age) undergoing cardiac surgery were included. The primary outcome of incidence of POD was assessed using the risk ratio (RR) with a fixed-effects model. Secondary analyses included the severity or duration of delirium, mortality at 30 days, length of hospital and intensive care unit (ICU) stay, duration of mechanical ventilatory support, the incidence of myocardial injury, new atrial fibrillation, renal and respiratory failure, postoperative infection and stroke, and the level of glucose and inflammatory factors.FINDINGS: A total 4 trials (n = 8448 patients) were included. Glucocorticoids did not significantly reduce the incidence of POD (RR = 0.99; 95%...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Source Type: research