Effectiveness of melatonin in preventing delirium in hospitalized patients: an umbrella review_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Weilin , ZHANG Chuchu , NI Qiqi , YI Jia , YAN Ran , WANG Li ,  ZHUANG Yiyu

Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, P. R. China;

Corresponding?author：

ZHUANG Yiyu, Email: zhuangyy@zju.edu.cn

Keywords：

Melatonin; Prevention; Hospitalized patients; Delirium; Umbrella review

DOI：

10.7507/1672-2531.202505084

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Objective To conduct an umbrella review and meta-analysis of the effectiveness of melatonin in preventing delirium in hospitalized patients. Methods Systematic reviews evaluating the effectiveness of melatonin for delirium prevention in hospitalized patients were retrieved from CNKI, VIP, WanFang Data, CBM, PubMed, Embase, CINAHL, Cochrane Library, and Web of Science. The search time frame spanned from database inception to March 20, 2025. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated via the GRADE system. Data analysis was performed using RevMan 5.4. Results A total of 30 systematic reviews were included, and 98 evidence items were extracted. Methodological quality assessment identified 13 high-quality, 2 moderate-quality, 8 low-quality, and 7 very low-quality studies. Evidence quality evaluation revealed 19 high-quality, 34 moderate-quality, 31 low-quality, and 14 very low-quality evidence items. A meta-analysis of re-extracted raw data demonstrated that melatonin significantly reduces the incidence of delirium in hospitalized patients (OR=0.51, 95%CI 0.41 to 0.63, P<0.001). Conclusion Melatonin demonstrates beneficial effects in preventing delirium in hospitalized patients. However, due to limitations in the number and quality of included literature, some findings warrant further validation and clarification through high-quality research.

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8.	劉海霞, 胡德華, 尹懷瓊. 傘狀評價—一種新型循證醫學分析方法. 中華流行病學雜志, 2020, 41(2): 261-266.
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11.	馬寧, 潘蓓, 鄧錫源, 等. 傘狀評價中文獻重疊的評估及處理. 中國循證醫學雜志, 2024, 24(10): 1212-1218.
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1. Prendergast NT, Tiberio PJ, Girard TD. Treatment of delirium during critical illness. Annu Rev Med, 2022, 73: 407-421.
2. Wibrow B, Martinez FE, Myers E, et al. Prophylactic melatonin for delirium in intensive care (pro-medic): a randomized controlled trial. Intensive Care Med, 2022, 48(4): 414-425.
3. 隋偉靜, 莊一渝, 陳香萍, 等. 住院患者譫妄嚴重度評估工具及臨床應用的研究進展. 中華急危重癥護理雜志, 2021, 2(5): 454-459.
4. Sadlonova M, Duque L, Smith D, et al. Pharmacologic treatment of delirium symptoms: a systematic review. Gen Hosp Psychiatry, 2022, 79: 60-75.
5. 宋欣. 預防性使用褪黑素對危重癥患者譫妄發生率的影響. 南昌: 南昌大學, 2024.
6. Liu L, Ma X, Song Z, et al. Effects of melatonin on the prevention of delirium in hospitalized older patients: systematic review and meta-analysis. BMC Pharmacol Toxicol, 2024, 25(1): 90.
7. Shin HW, Kwak JS, Choi YJ, et al. Efficacy and safety of perioperative melatonin for postoperative delirium in patients undergoing surgery: a systematic review and meta-analysis. J Int Med Res, 2024, 52(5): 03000605241239854.
8. 劉海霞, 胡德華, 尹懷瓊. 傘狀評價—一種新型循證醫學分析方法. 中華流行病學雜志, 2020, 41(2): 261-266.
9. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
10. Neumann I, Santesso N, Akl EA, et al. A guide for health professionals to interpret and use recommendations in guidelines developed with the GRADE approach. J Clin Epidemiol, 2016, 72: 45-55.
11. 馬寧, 潘蓓, 鄧錫源, 等. 傘狀評價中文獻重疊的評估及處理. 中國循證醫學雜志, 2024, 24(10): 1212-1218.
12. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021, 372: n71.
13. Salluh JI, Wang H, Schneider EB, et al. Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ, 2015, 350: h2538.

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