{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:20:21Z","timestamp":1791372021712,"version":"4.3.1"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81973305"],"award-info":[{"award-number":["81973305"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Delirium is a common and serious neurobehavioral syndrome, associated with prolonged hospital stays, and increased morbidity and mortality. As it remains unclear whether suvorexant with or without ramelteon prevents delirium in elderly hospitalized patients, we conducted a systematic review and meta\u2010analysis to evaluate, searching the PubMed, Cochrane Library, Web of Science, EMBASE, and EBSCOhost databases for all randomized controlled trials (RCTs), case\u2013control studies, and cohort studies that investigated the effects of suvorexant with or without ramelteon on delirium in adult hospitalized patients. The primary outcome was the incidence of delirium. Two randomized controlled trials, 7 cohort studies and 2 case\u2013control studies involving 2594 patients were included in this meta\u2010analysis. The results showed that both suvorexant alone (odds ratio (OR)\u00a0=\u00a00.30, 95% confidence interval (CI): 0.14\u20130.65, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002) and suvorexant with ramelteon (OR\u00a0=\u00a00.39, 95% CI 0.23\u20130.65, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0003) reduced the incidence of delirium in adult hospitalized patients. Six studies involved the use of benzodiazepines; subgroup analysis performed separately in the suvorexant alone and suvorexant with ramelteon groups indicated that when benzodiazepine was administered, suvorexant with ramelteon was effective at reducing the incidence of delirium (OR\u00a0=\u00a00.53, 95% CI 0.37\u20130.74, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0002), but no significant difference was observed for suvorexant alone (OR\u00a0=\u00a00.40, 95% CI 0.11\u20131.53, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.18). The current literature thus supports the effectiveness of suvorexant with or without ramelteon for delirium prevention, although suvorexant alone failed to significantly reduce the incidence of delirium when benzodiazepine was administered. The present study was limited by the significant heterogeneity among the included studies, and caution should be exercised when interpreting the results. This study was registered in the PROSPERO database (CRD4202017964).<\/jats:p>","DOI":"10.1111\/psyg.12792","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T07:51:11Z","timestamp":1639036271000},"page":"259-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Suvorexant with or without ramelteon to prevent delirium: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"22","author":[{"given":"Yu","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaisheng","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5079-6826","authenticated-orcid":false,"given":"Yunyang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Nanfang Hospital Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001772"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0141-2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1013"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4860-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-00223-4"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2013.09.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.09.004"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2020.02.020"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70053-5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/892624"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2004.09.007"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.01.019"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.17394"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpi.12644"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.19m12865"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.09.024"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021043"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_7_21_1","unstructured":"WellsGA SheaB O'ConnellDet al.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses. 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