Summary of findings for the main comparison. Benzodiazepines (lorazepam) vs placebo for treatment of delirium in non‐ICU settings.
| Benzodiazepines (lorazepam) vs placebo for treatment of delirium in non‐ICU settings | ||||||
| Patient or population: end‐of‐life patients with advanced cancer and an episode of agitated delirium Settings: acute palliative care unit Intervention: benzodiazepine (lorazepam) + haloperidol Comparison: placebo + haloperidol | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with Placebo | Risk with Benzodiazepines (lorazepam) | |||||
| Length of delirium episode | See comment | See comment | See comment | See comment | See comment | Outcome not reported |
| Severity of delirium change in MDAS, high = worse Follow‐up: baseline to 8 hours | Mean was 0.4 | MD 2.10 higher (0.96 lower to 5.16 higher) | ‐ | 50 (1 study) | ⊕⊕⊝⊝ low1 | |
| Any adverse event | See comment | See comment | See comment | See comment | See comment | Outcome not reported |
| Length of hospital admission (days) Follow‐up: 164 hours | Mean was 6 | MD 0.00 higher (3.45 lower to 3.45 higher) | ‐ | 58 (1 study) | ⊕⊕⊝⊝ low1 | |
| Mortality from all causes Follow‐up: 8 hours | 103 per 1000 |
34 per 1000 (4 to 312) |
RR 0.33 (0.04 to 3.02) |
58 (1 study) | ⊕⊕⊝⊝ low1 | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; ESAS: Edmonton symptom assessment system ICU: intensive care unit; MD: mean difference; MDAS: memorial delirium assessment scale; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1 Downgraded by two levels due to imprecision: very small sample size and very wide CIs