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Objective <p>To evaluate whether early mobilisation can reduce the incidence of delirium in critically ill patients and to assess the methodological quality of published studies.</p> Methods <p>Three electronic databases, PubMed, Embase and the Cochrane Library, were searched for relevant studies published up to 2&#xa0;March 2024. Articles were screened independently by two reviewers, based on inclusion and exclusion criteria, and a&#xa0;meta-analysis was performed using RevMan&#xa0;5.3 software with a&#xa0;random-effects model.</p> Results <p>A&#xa0;total of 18&#xa0;studies (intervention group: 1794 participants, control group: 2129 participants) were included in the systematic review, with 18&#xa0;studies included in the meta-analysis. Early mobilisation was found to reduce the risk of delirium in critically ill populations, with a&#xa0;pooled odds ratio of 0.65 (95% confidence interval [CI] 0.49–0.86; <i>P</i> = 0.003; I<sup>2</sup> = 59%). Additionally, two studies found that early mobilisation did not change the duration of delirium in critically ill populations, with a&#xa0;pooled mean difference of −1.53 (95% CI −3.48 to 0.41; <i>P</i> = 0.12; I<sup>2</sup> = 37%). Subgroup analysis revealed that early mobilisation maintained its preventive effect on delirium in the before/after intervention studies, studies published before 2018 and studies with a&#xa0;moderate methodological rating.</p> Conclusion <p>As a&#xa0;nonpharmacological intervention, early mobilisation may help reduce the risk of delirium and shorten its duration in critically ill patients compared with standard treatment and may potentially become a&#xa0;novel strategy for delirium prevention in future intensive care unit settings.</p>

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Preventive effects of early mobilisation on delirium incidence in critically ill patients: systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月14日

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  • Li Zhou,
  • Fei Xie,
  • Yangyang Zeng,
  • Xi Xia,
  • Rui Wang,
  • Yongjie Cai,
  • Yu Lei,
  • Fengjiao Xu,
  • Xi Li,
  • Bing Chen

摘要

Objective

To evaluate whether early mobilisation can reduce the incidence of delirium in critically ill patients and to assess the methodological quality of published studies.

Methods

Three electronic databases, PubMed, Embase and the Cochrane Library, were searched for relevant studies published up to 2 March 2024. Articles were screened independently by two reviewers, based on inclusion and exclusion criteria, and a meta-analysis was performed using RevMan 5.3 software with a random-effects model.

Results

A total of 18 studies (intervention group: 1794 participants, control group: 2129 participants) were included in the systematic review, with 18 studies included in the meta-analysis. Early mobilisation was found to reduce the risk of delirium in critically ill populations, with a pooled odds ratio of 0.65 (95% confidence interval [CI] 0.49–0.86; P = 0.003; I2 = 59%). Additionally, two studies found that early mobilisation did not change the duration of delirium in critically ill populations, with a pooled mean difference of −1.53 (95% CI −3.48 to 0.41; P = 0.12; I2 = 37%). Subgroup analysis revealed that early mobilisation maintained its preventive effect on delirium in the before/after intervention studies, studies published before 2018 and studies with a moderate methodological rating.

Conclusion

As a nonpharmacological intervention, early mobilisation may help reduce the risk of delirium and shorten its duration in critically ill patients compared with standard treatment and may potentially become a novel strategy for delirium prevention in future intensive care unit settings.