Cardiothoracic & vascular anesthesia
Perioperative dexmedetomidine for the prevention of postoperative delirium after cardiac surgery: a systematic review, Bayesian meta-analysis, and Bayesian re-analysis of the DECADE trial
Pooled resultResult — go to the resultOdds ratio 0.67 95% CrI 0.45–0.92Authors' conclusion
Pooled evidence suggests dexmedetomidine is associated with reduced incidence of postoperative delirium; however, this is highly sensitive to the possibility of publication bias.
Study context
- Population
- Adults undergoing cardiac surgery
- Participants
- 3,539 adults · 12 RCTs
- Comparison
- Perioperative dexmedetomidine vs control
- Outcome
- Incidence of postoperative delirium (MCID: OR >1.20 or <0.84)
Methodological detailsrandom-effects, weakly informative priors, Bayesian model averaging for publication bias
- Random-effects
- Weakly informative priors
- Bayesian model averaging for publication bias
Pooled result
As reported in the abstract
Odds ratio
0.67
95% CrI 0.45–0.92
Dexmedetomidine vs Control
OR 0.67 (95% CrI 0.45–0.92)
Further pooled results
| Outcome | OR (95% CrI) | |
|---|---|---|
| Postoperative delirium, adjusted for publication biasDexmedetomidine vs Control · CrI | 1.15 (0.93–2.51) | |
| 0.20.5125Odds ratio (log scale) |
- Postoperative delirium, adjusted for publication bias: 95% CrI
Bayesian re-analysis of DECADE, vague prior
- Posterior probability of any benefit
- 1.5%
- Probability of minimum clinically important difference (MCID) for benefit
- 0.1%
Bayesian re-analysis of DECADE, meta-analysis-derived priors
- Probability of MCID for benefit, unadjusted prior
- 17.8%
- Probability of MCID for benefit, prior adjusted for publication bias
- 0.2%
Original publication
Perioperative dexmedetomidine for the prevention of postoperative delirium after cardiac surgery: a systematic review, Bayesian meta-analysis, and Bayesian re-analysis of the DECADE trial. Br J Anaesth. Published 30 April 2025. doi:10.
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