ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Perioperative switching to lemborexant for prevention of delirium in older cancer patients with insomnia taking GABA
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePostoperative delirium (POD) occurs in about one-third of patients and the incidence increases with age. The rate of missed delirium is 60%-70%, and there has recently been a shift from early detection and treatment to preventive strategies to reduce risk. While GABA
methodsA retrospective study was conducted in cancer patients aged ≥ 75 years who visited the Department of Psycho-Oncology at the National Cancer Center Hospital in Japan and were taking a GRA daily for insomnia before surgery under general anesthesia. Delirium was screened at least once daily with the Nursing Delirium Screening Scale on postoperative days 0-6 (positive if ≥ 2). We used a two-group intention-to-treat (ITT) framework, classifying patients according to a psycho-oncologist-verified preoperative switch to lemborexant.
resultsFifty patients satisfied eligibility. POD occurred in 1/17 (5.9%) in the Switch group and 15/33 (45.5%) in the Continue group; RD -39.6 percentage points (95% CI -59.9 to -19.2), RR 0.13 (95% CI 0.02-0.90), OR 0.08 (95% CI 0.01-0.63), p = 0.005.
conclusionA preoperative switch policy to lemborexant monotherapy was associated with a lower observed risk of POD. Given the observational, unadjusted design, these associations are hypothesis-generating and cannot establish causality.
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