Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients: the multinational AID-ICU inception cohort study.
- Collet MO Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. marie.oxenboell-collet@regionh.dk.
- Caballero J Hospital Universitari Arnau de Vilanova de Lleida-IRBLleida, Hospital Universitari Vall d'Hebron-VHIR, Universitat Autònoma de Barcelona-UAB, Barcelona, Spain.
- Sonneville R Department of Intensive Care Medicine and Infectious Diseases, Bichat Claude Bernard Hospital, AP-HP, Paris, France.
- Bozza FA National Institute of Infectious Disease, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, Brazil.
- Nydahl P Department of Nursing Research, University Hospital of Schleswig-Holstein, Kiel, Germany.
- Schandl A Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
- Wøien H Division of Emergencies and Intensive Care, Oslo University Hospital, Oslo, Norway.
- Citerio G Neuroanaesthesia and Neurointensive Care, School of Medicine and Surgery, H San Gerardo Monza, University of Milano Bicocca, Milan, Italy.
- van den Boogaard M Department Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
- Hästbacka J Division of Intensive Care, Department of Anaesthesia, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Haenggi M Department of Intensive Care Medicine, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland.
- Colpaert K Intensive Care Unit, University Hospital Gent, Ghent, Belgium.
- Rose L Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Barbateskovic M Centre for Research in Intensive Care, Copenhagen, Denmark.
- Lange T Centre for Research in Intensive Care, Copenhagen, Denmark.
- Jensen A Centre for Research in Intensive Care, Copenhagen, Denmark.
- Krog MB Department of Intensive Care, University Hospital Aarhus, Aarhus, Denmark.
- Egerod I Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- Nibro HL Centre for Research in Intensive Care, Copenhagen, Denmark.
- Wetterslev J Centre for Research in Intensive Care, Copenhagen, Denmark.
- Perner A Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- 2018-05-17
Published in:
- Intensive care medicine. - 2018
Cohort
Critical care
Delirium
Haloperidol
ICU
Adolescent
Adult
Antipsychotic Agents
Brazil
Canada
Critical Care
Delirium
Europe
Haloperidol
Humans
Intensive Care Units
Prevalence
Prospective Studies
Risk Factors
English
PURPOSE
We assessed the prevalence and variables associated with haloperidol use for delirium in ICU patients and explored any associations of haloperidol use with 90-day mortality.
METHODS
All acutely admitted, adult ICU patients were screened during a 2-week inception period. We followed the patient throughout their ICU stay and assessed 90-day mortality. We assessed patients and their variables in the first 24 and 72 h in ICU and studied their association together with that of ICU characteristics with haloperidol use.
RESULTS
We included 1260 patients from 99 ICUs in 13 countries. Delirium occurred in 314/1260 patients [25% (95% confidence interval 23-27)] of whom 145 received haloperidol [46% (41-52)]. Other interventions for delirium were benzodiazepines in 36% (31-42), dexmedetomidine in 21% (17-26), quetiapine in 19% (14-23) and olanzapine in 9% (6-12) of the patients with delirium. In the first 24 h in the ICU, all subtypes of delirium [hyperactive, adjusted odds ratio (aOR) 29.7 (12.9-74.5); mixed 10.0 (5.0-20.2); hypoactive 3.0 (1.2-6.7)] and circulatory support 2.7 (1.7-4.3) were associated with haloperidol use. At 72 h after ICU admission, circulatory support remained associated with subsequent use of haloperidol, aOR 2.6 (1.1-6.9). Haloperidol use within 0-24 h and within 0-72 h of ICU admission was not associated with 90-day mortality [aOR 1.2 (0.5-2.5); p = 0.66] and [aOR 1.9 (1.0-3.9); p = 0.07], respectively.
CONCLUSIONS
In our study, haloperidol was the main pharmacological agent used for delirium in adult patients regardless of delirium subtype. Benzodiazepines, other anti-psychotics and dexmedetomidine were other frequently used agents. Haloperidol use was not statistically significantly associated with increased 90-day mortality.
We assessed the prevalence and variables associated with haloperidol use for delirium in ICU patients and explored any associations of haloperidol use with 90-day mortality.
METHODS
All acutely admitted, adult ICU patients were screened during a 2-week inception period. We followed the patient throughout their ICU stay and assessed 90-day mortality. We assessed patients and their variables in the first 24 and 72 h in ICU and studied their association together with that of ICU characteristics with haloperidol use.
RESULTS
We included 1260 patients from 99 ICUs in 13 countries. Delirium occurred in 314/1260 patients [25% (95% confidence interval 23-27)] of whom 145 received haloperidol [46% (41-52)]. Other interventions for delirium were benzodiazepines in 36% (31-42), dexmedetomidine in 21% (17-26), quetiapine in 19% (14-23) and olanzapine in 9% (6-12) of the patients with delirium. In the first 24 h in the ICU, all subtypes of delirium [hyperactive, adjusted odds ratio (aOR) 29.7 (12.9-74.5); mixed 10.0 (5.0-20.2); hypoactive 3.0 (1.2-6.7)] and circulatory support 2.7 (1.7-4.3) were associated with haloperidol use. At 72 h after ICU admission, circulatory support remained associated with subsequent use of haloperidol, aOR 2.6 (1.1-6.9). Haloperidol use within 0-24 h and within 0-72 h of ICU admission was not associated with 90-day mortality [aOR 1.2 (0.5-2.5); p = 0.66] and [aOR 1.9 (1.0-3.9); p = 0.07], respectively.
CONCLUSIONS
In our study, haloperidol was the main pharmacological agent used for delirium in adult patients regardless of delirium subtype. Benzodiazepines, other anti-psychotics and dexmedetomidine were other frequently used agents. Haloperidol use was not statistically significantly associated with increased 90-day mortality.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1007/s00134-018-5204-y
- PMID 29767323
- Persistent URL
- https://sonar.ch/global/documents/185172
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