Cusimano JM, et al. - In a cohort of patients on melatonin in the surgical ICU (SICU), investigators wanted to identify independent factors that predict delirium, via a retrospective, observational case-cohort analysis of these patients. A positive response to the Confusion Assessment Method for the ICU (CAM-ICU) was used to define cases. An increased incidence of delirium in baseline CAM-ICU–positive patients who had emergency surgery within 24 hours of admission vs baseline CAM-ICU–negative patients after melatonin administration were found via stratified analysis. More researches are required to ascertain the role of melanin in deleriogenesis and to explain its utility as a delirioprotectant following surgery and in critical care patients.