Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3773-3786
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3773
Melatonin intervention to prevent delirium in hospitalized patients: A meta-analysis
Wei You, Xiao-Yu Fan, Cheng Lei, Chen-Cong Nie, Yao Chen, Xue-Lian Wang
Wei You, Yao Chen, Xue-Lian Wang, Emergency Department Intensive Care Unit, Zigong Fourth People's Hospital, Zigong 643000, Sichuan Province, China
Xiao-Yu Fan, Department of General Surgery, Zigong Fourth People's Hospital, Zigong 643000, Sichuan Province, China
Cheng Lei, School of Public Health and Management, Chongqing Medical University, Chongqing 400000, Chongqing, China
Chen-Cong Nie, Department of Nursing, Zigong Fourth People's Hospital, Zigong 643000, Sichuan Province, China
Author contributions: You W and Fan XY contributed equally to this work; You W and Cheng L contributed to the design and provided the analysis; You W and Fan XY completed the data collection and provided statistical support; Nie CC, Chen Y, and Wang XL contributed to the manuscript preparation.
Supported by the Scientific Research Project of Sichuan Provincial Health Commission, No. 19PJ045.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed following the Creative Commons Attribution-Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Yu Fan, BSc, Chief Nurse, Department of General Surgery, Zigong Fourth People's Hospital, No. 2 Tanmulin Street, Ziliujing District, Zigong 643000, Sichuan Province, China. 453611550@qq.com
Received: July 5, 2021
Peer-review started: July 5, 2021
First decision: July 26, 2021
Revised: July 26, 2021
Accepted: April 3, 2022
Article in press: April 3, 2022
Published online: April 26, 2022
ARTICLE HIGHLIGHTS
Research background

From an evidence-based perspective, this study examined the influence of melatonin on the prevention of delirium in hospitalized patients. The results suggest that in patients with delusional behavior and dermatology ward (ICU) patients, the effect of melatonin on delirium was confirmed. Thus, melatonin may be a treatment option for delirium with careful design for different types of respondents, and more standardized options.

Research motivation

Recently, research on the effect of melatonin on the occurrence of delirium in hospitalized patients has attracted more and more attention. However, it is unknown whether melatonin can play a role in different types of hospitalized patients. The use of melatonin to prevent delirium has aroused increasing interest in doctors. However, whether melatonin can play a role in different types of hospitalized patients needs further research.

Research objectives

We conducted a meta-analysis, mainly for one purpose. It was based on high-quality studies with a large enough sample size to calculate a reliable estimate of the incidence of melatonin in preventing delirium in hospitalized patients, and to evaluate the role of melatonin in reducing the incidence of delirium in different types of patients.

Research methods

Various databases were searched and relevant studies on the incidence of delirium treated with melatonin in hospitalized patients were retrieved. In our meta-analysis, fixed-effects and random-effects models were used to estimate the incidence of delirium in hospitalized patients. Publication and sensitivity bias analysis was used to test the robustness of the data.

Research results

A total of 18 studies involving 2137 patients were eligible for this review. Melatonin was shown to be more effective in reducing the incidence of delirium in hospitalized medical patients, and the findings were statistically significant (P < 0.01).

Research conclusions

Melatonin can reduce the incidence of delirium in medical patients, but its impact on reducing the incidence of delirium in patients with behavioral disorders and ICU patients is unclear.

Research perspectives

Our meta-analysis showed that melatonin can reduce the incidence of delirium in hospitalized medical patients. Unfortunately, limited research has shown that the benefit is not seen in surgical patients or ICU patients. Further study to determine the role of melatonin in reducing the incidence of delirium in surgical and ICU patients is required.