Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis
BackgroundThe effectiveness of melatonin and its analogs in preventing postoperative delirium (POD) following cardiac surgery is controversial. The purpose of this systematic review and meta-analysis was to confirm the benefits of melatonin and its analogs on delirium prevention in adults who underw...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.888211/full |
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| author | Yunyang Han Yu Tian Jie Wu Xiaoqin Zhu Wei Wang Zhenhua Zeng Zaisheng Qin |
| author_facet | Yunyang Han Yu Tian Jie Wu Xiaoqin Zhu Wei Wang Zhenhua Zeng Zaisheng Qin |
| author_sort | Yunyang Han |
| collection | DOAJ |
| description | BackgroundThe effectiveness of melatonin and its analogs in preventing postoperative delirium (POD) following cardiac surgery is controversial. The purpose of this systematic review and meta-analysis was to confirm the benefits of melatonin and its analogs on delirium prevention in adults who underwent cardiac surgery.MethodsWe systematically searched the PubMed, Cochrane Library, Web of Science, Embase, and EBSCOhost databases, the last search was performed in October 2021 and repeated before publication. The controlled studies were included if investigated the impact of melatonin and its analogs on POD in adults who underwent cardiac surgery. The primary outcome was the incidence of delirium. The Stata statistical software 17.0 was used to perform this study.ResultsThis meta-analysis included eight randomized controlled trials (RCTs) and two cohort studies with a total of 1,714 patients. The results showed that melatonin and ramelteon administration were associated with a significantly lower incidence of POD in adults who underwent cardiac surgery (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.29–0.74; P = 0.001). The subgroup analyses confirmed that melatonin 3 mg (OR, 0.37; 95% CI, 0.18–0.76; P = 0.007) and 5 mg (OR, 0.34; 95% CI, 0.21–0.56; P < 0.001) significantly reduced the incidence of POD.ConclusionMelatonin at dosages of 5 and 3 mg considerably decreased the risk of delirium in adults who underwent cardiac surgery, according to our results. Cautious interpretation of our results is important owing to the modest number of studies included in this meta-analysis and the heterogeneity among them.Systematic Review RegistrationPROSPERO registration number: CRD42021246984. |
| first_indexed | 2024-12-12T03:40:27Z |
| format | Article |
| id | doaj.art-36967c4ae3e7489d9bb2c5fa31d8600c |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T03:40:27Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-36967c4ae3e7489d9bb2c5fa31d8600c2022-12-22T00:39:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.888211888211Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-AnalysisYunyang Han0Yu Tian1Jie Wu2Xiaoqin Zhu3Wei Wang4Zhenhua Zeng5Zaisheng Qin6Department of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, ChinaDepartment of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Anesthesiology, Guangdong Women and Children Hospital, Guangzhou, ChinaDepartment of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaBackgroundThe effectiveness of melatonin and its analogs in preventing postoperative delirium (POD) following cardiac surgery is controversial. The purpose of this systematic review and meta-analysis was to confirm the benefits of melatonin and its analogs on delirium prevention in adults who underwent cardiac surgery.MethodsWe systematically searched the PubMed, Cochrane Library, Web of Science, Embase, and EBSCOhost databases, the last search was performed in October 2021 and repeated before publication. The controlled studies were included if investigated the impact of melatonin and its analogs on POD in adults who underwent cardiac surgery. The primary outcome was the incidence of delirium. The Stata statistical software 17.0 was used to perform this study.ResultsThis meta-analysis included eight randomized controlled trials (RCTs) and two cohort studies with a total of 1,714 patients. The results showed that melatonin and ramelteon administration were associated with a significantly lower incidence of POD in adults who underwent cardiac surgery (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.29–0.74; P = 0.001). The subgroup analyses confirmed that melatonin 3 mg (OR, 0.37; 95% CI, 0.18–0.76; P = 0.007) and 5 mg (OR, 0.34; 95% CI, 0.21–0.56; P < 0.001) significantly reduced the incidence of POD.ConclusionMelatonin at dosages of 5 and 3 mg considerably decreased the risk of delirium in adults who underwent cardiac surgery, according to our results. Cautious interpretation of our results is important owing to the modest number of studies included in this meta-analysis and the heterogeneity among them.Systematic Review RegistrationPROSPERO registration number: CRD42021246984.https://www.frontiersin.org/articles/10.3389/fcvm.2022.888211/fullmelatonincardiacmeta-analysisramelteonsystematic reviewpostoperative delirium |
| spellingShingle | Yunyang Han Yu Tian Jie Wu Xiaoqin Zhu Wei Wang Zhenhua Zeng Zaisheng Qin Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis Frontiers in Cardiovascular Medicine melatonin cardiac meta-analysis ramelteon systematic review postoperative delirium |
| title | Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis |
| title_full | Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis |
| title_fullStr | Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis |
| title_short | Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis |
| title_sort | melatonin and its analogs for prevention of post cardiac surgery delirium a systematic review and meta analysis |
| topic | melatonin cardiac meta-analysis ramelteon systematic review postoperative delirium |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.888211/full |
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