Antipsychotics for Preventing Delirium in Hospitalized Adults
Authors: Maria Vargas, Pasquale Buonano, Annachiara Marra, Carmine Iacovazzo, Giuseppe Servillo
Journal: Annals of Internal Medicine (2020)

Letters3 March 2020Antipsychotics for Preventing Delirium in Hospitalized AdultsMaria Vargas, MD, Pasquale Buonano, MD, Annachiara Marra, PhD, Carmine Iacovazzo, MD, and Giuseppe Servillo, MDMaria Vargas, MDUniversity of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Search for more papers by this author, Pasquale Buonano, MDUniversity of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Search for more papers by this author, Annachiara Marra, PhDUniversity of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Search for more papers by this author, Carmine Iacovazzo, MDUniversity of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Search for more papers by this author, and Giuseppe Servillo, MDUniversity of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0754 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Oh and colleagues' (1) systematic review and meta-analysis on the benefits and harms of antipsychotics for preventing delirium in a cohort of surgical and critical care patients with interest. Their findings, including the results of 14 randomized controlled trials (RCTs), did not support the routine use of haloperidol or second-generation antipsychotics for this purpose.The fragility index (FI), an intuitive measure of the robustness of RCTs, was introduced for use in critical care medicine (2). Studies with higher FI scores have more robust findings than those with low scores. The FI was recently applied to ...References1. Oh ES, Needham DM, Nikooie R, et al. Antipsychotics for preventing delirium in hospitalized adults. A systematic review. Ann Intern Med. 2019;171:474-84. [PMID: 31476766]. doi:10.7326/M19-1859 LinkGoogle Scholar2. Ridgeon EE, Young PJ, Bellomo R, et al. The fragility index in multicenter randomized controlled critical care trials. Crit Care Med. 2016;44:1278-84. [PMID: 26963326] doi:10.1097/CCM.0000000000001670 CrossrefMedlineGoogle Scholar3. Vargas M, Servillo G. The end of corticosteroid in sepsis: fragile results from fragile trials. Crit Care Med. 2018;46:e1228. [PMID: 30444828] doi:10.1097/CCM.0000000000003396 CrossrefMedlineGoogle Scholar4. Vargas M, Servillo G. Liberal versus conservative oxygen therapy in critically ill patients: using the fragility index to determine robust results [Letter]. Crit Care. 2019;23:132. [PMID: 30999939] doi:10.1186/s13054-018-2165-z CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Naples Federico II, Naples, Italy (M.V., P.B., A.M., C.I., G.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0754. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntipsychotics for Preventing Delirium in Hospitalized Adults Esther S. Oh , Dale M. Needham , Roozbeh Nikooie , Lisa M. Wilson , Allen Zhang , Karen A. Robinson , and Karin J. Neufeld Antipsychotics for Preventing Delirium in Hospitalized Adults Esther S. Oh , Dale M. Needham , Lisa M. Wilson , Karen A. Robinson , and Karin J. Neufeld Metrics 3 March 2020Volume 172, Issue 5Page: 365-366KeywordsAntipsychoticsCritical careDeliriumDisclosurePatientsRelative riskSystematic reviews ePublished: 3 March 2020 Issue Published: 3 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...