ICU sedation, delirium & recovery
Heterogeneity in the definition of delirium in intensive care units (ICUs) and association with the intervention effect in randomized controlled trials: a meta-epidemiological study
Primary result · Two-step methodResult — go to the resultROR 0.54 95% CI 0.27–1.08Authors' conclusion
The definition of delirium was heterogeneous across RCTs, with one-fifth not reporting how they evaluated delirium. We did not find a significant association with intervention effect in the primary analysis. The secondary analysis including more studies revealed significantly larger intervention effects in trials using a non-validated versus a validated definition.
Study context
- Population
- Randomized controlled trials (RCTs) included in meta-analyses of delirium prevention or treatment strategies in ICUs41 meta-analyses
- Participants
- 149 participants
- Comparison
- Trials using a validated vs non-validated definition of delirium
- Validatedn = 109reference
- Non-validatedn = 40
- Primary endpoint
- Intervention effect (ratio of odds ratios, ROR <1 = larger effects in trials using a non-validated definition)
Methodological detailstwo-step method (primary analysis), multilevel model (secondary analysis)
- Two-step method (primary analysis)
- Multilevel model (secondary analysis)
Primary result
Two-step method
Ratio of odds ratios (ROR)
0.54
95% CI 0.27–1.08
Non-validated vs Validated
ROR 0.54 (95% CI 0.27–1.08)
As reported in the abstract
Further findings
Definition of delirium used
| Outcome | ROR (95% CI) | |
|---|---|---|
| Intervention effect, multilevel model (secondary analysis)12 meta-analyses (67 RCTs) | 0.36 (0.21–0.62) | |
| 0.20.5125Ratio of odds ratios (log scale) |
- Definition of delirium used — Definition not reported
- 31 [20.8%]
Intervention effect, multilevel model (secondary analysis)
- Significantly larger effects in trials using a non-validated definition
Original publication
Heterogeneity in the definition of delirium in ICUs and association with the intervention effect in randomized controlled trials: a meta-epidemiological study. Crit Care. Published 4 May 2023. doi:10.
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