Non-pharmacological interventions for preventing delirium in older adults in intensive care units: a systematic review and network meta-analysis.

OBJECTIVE

This study compares the effects of non-pharmacological interventions on delirium incidence and other outcomes in elderly patients in ICU.

METHODS

A comprehensive search of eight electronic databases to identify randomized controlled trials (RCTs). The search covered studies from the inception to June 2024. Two reviewers independently screened titles and abstracts according to pre-defined inclusion and exclusion criteria. The analysis was conducted using Stata (version 15.0).

RESULTS

A total of 38 studies involving 7229 critically ill patients and 12 interventions were included. While the network meta-analysis results suggest that nurse-led cluster nursing is the superior intervention for reducing delirium incidence (SUCRA=80.5 %), delirium duration (SUCRA=92.2 %), and mechanical ventilation duration (SUCRA=84.4 %) in elderly patients, it's important to note that physical exercise (SUCRA=92.9 %) and cluster care (SUCRA=82.4 %) also demonstrated significant effects in decreasing ICU stay duration. However, these findings should be approached with caution.

CONCLUSION

Our findings indicated that nurse-led cluster nursing showed reliable performance in managing outcome indicators of delirium in the elderly. Our study provides important evidence for clinical medical staff to optimize intensive care programs, but the results should be interpreted with caution.