2026-10-14T18:10:49Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33981670 2026-09-24T11:17:56Z category_15 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Multicomponent non-pharmacological interventions for preventing delirium in critically ill patients: a systematic review and meta-analysis of randomized controlled trials.docx Shiting Wang (11829622) Jiamin Lei (25103716) Wenjing Huang (172392) Huajian Chen (4610293) Shufang Li (3183168) Neuroscience delirium intensive care unit meta-analysis multicomponent non-pharmacological interventions systematic review Background<p>It is necessary to evaluate the efficacy of multicomponent non-pharmacological interventions in preventing and managing intensive care unit (ICU) delirium and identify the most effective intervention combinations.</p>Methods<p>A systematic literature search was conducted in PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest Dissertations and Theses A&I databases from inception to July 3, 2026, supplemented by a hand search of prior meta-analyses. Only randomized trials were included. Meta-analysis was performed using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Random-effects models with restricted maximum likelihood estimation and modified Hartung-Knapp confidence intervals were used. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized controlled trials. The certainty of evidence was assessed using the GRADE approach.</p>Results<p>The search identified 13 randomized controlled trials encompassing 5,525 patients. Multicomponent interventions significantly reduced delirium incidence (RR 0.53, 95% CI [0.36, 0.76], I² = 72.5%, low-certainty evidence). The effect remained significant after excluding the two cluster-randomized trials (RR 0.45, 95% CI 0.30–0.67; I² = 55.7%), the active-control trial (RR 0.55, 95% CI 0.38–0.79; I² = 73.0%), and all three trials simultaneously (RR 0.46, 95% CI 0.31–0.70; I² = 57.0%). In exploratory subgroup analysis, the within-subgroup pooled estimate for component pattern B, comprising cognitive assessment and stimulation, reorientation, sleep and environmental management, family or community support, and physical activity, showed a reduced incidence of delirium (RR 0.43, 95% CI [0.23, 0.82]); however, the formal test for subgroup differences was not significant (p = 0.604). No statistically significant effects were found for delirium duration, ICU or hospital length of stay, delirium-free days, or mortality.</p>Conclusion<p>This study demonstrated that multi-component interventions effectively reduce delirium incidence in critically ill patients. The evidence did not establish that one component combination was superior to another.</p>Systematic review registration<p>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024592821.</p> 2026-09-24T11:17:56Z Dataset Dataset 10.3389/fnins.2026.1927572.s001 https://figshare.com/articles/dataset/Supplementary_file_1_Multicomponent_non-pharmacological_interventions_for_preventing_delirium_in_critically_ill_patients_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials_docx/33981670 CC BY 4.0