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Hartford Foundation","doi-asserted-by":"publisher","award":["2009\u20130079"],"award-info":[{"award-number":["2009\u20130079"]}],"id":[{"id":"10.13039\/100000909","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K07AG041835"],"award-info":[{"award-number":["K07AG041835"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01AG031720"],"award-info":[{"award-number":["P01AG031720"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of antipsychotic medications in preventing and treating delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      PubMed,\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      ,\n                      <jats:styled-content style=\"fixed-case\">CINAHL<\/jats:styled-content>\n                      , and ClinicalTrials.gov databases were searched from January 1, 1988, to November 26, 2013.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adult surgical and medical inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Antipsychotic administration for delirium prevention or treatment in randomized controlled trials or cohort studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Two authors independently reviewed all citations, extracted relevant data, and assessed studies for potential bias. Heterogeneity was considered as chi\u2010square\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.1 or I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0&gt;\u00a050%. Using a random\u2010effects model (I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0&gt;\u00a050%) or a fixed\u2010effects model (I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0&lt;\u00a050%), odds ratios (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      s) were calculated for dichotomous outcomes (delirium incidence and mortality), and mean or standardized mean difference for continuous outcomes (delirium duration, severity, hospital and intensive care unit (\n                      <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                      ) length of stay (\n                      <jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content>\n                      )). Sensitivity analyses included postoperative prevention studies only, exclusion of studies with\u00a0high risk of bias, and typical versus atypical antipsychotics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Screening of 10,877 eligible records identified 19 studies. In seven studies comparing antipsychotics with placebo or no treatment for delirium prevention after surgery, there was no significant effect on delirium incidence (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a0=\u00a00.56, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      )\u00a0=\u00a00.23\u20131.34, I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a093%). Using data reported from all 19 studies, antipsychotic use was not associated with change in delirium duration, severity, or hospital or\n                      <jats:styled-content style=\"fixed-case\">ICU LOS<\/jats:styled-content>\n                      , with high heterogeneity among studies. No association with mortality was detected (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a0=\u00a00.90, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a00.62\u20131.29, I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence does not support the use of antipsychotics for prevention or treatment of delirium. Additional methodologically rigorous studies using standardized outcome measures are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.14076","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T02:53:02Z","timestamp":1458701582000},"page":"705-714","source":"Crossref","is-referenced-by-count":424,"title":["Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"64","author":[{"given":"Karin J.","family":"Neufeld","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences School of Medicine Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jirong","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Geriatrics West China Hospital Sichuan University Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas N.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine University of Colorado Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon K.","family":"Inouye","sequence":"additional","affiliation":[{"name":"Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts"},{"name":"Institute for Aging Research Hebrew Senior Life Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale M.","family":"Needham","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Department of Medicine School of Medicine Johns Hopkins University Baltimore Maryland"},{"name":"Department of Physical Medicine and Rehabilitation School of Medicine Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1013"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53156.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.08.004"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13281"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.10.019"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_7_10_1","unstructured":"Clinical Practice Guideline for Postoperative Delirium in Older Adults[on\u2010line]. 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