TY - JOUR
T1 - Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients
T2 - the multinational AID-ICU inception cohort study
AU - the AID-ICU cohort study co-authors
AU - Collet, Marie O.
AU - Caballero, Jesús
AU - Sonneville, Romain
AU - Bozza, Fernando A.
AU - Nydahl, Peter
AU - Schandl, Anna
AU - Wøien, Hilden
AU - Citerio, Giuseppe
AU - van den Boogaard, Mark
AU - Hästbacka, Johanna
AU - Haenggi, Matthias
AU - Colpaert, Kirsten
AU - Rose, Louise
AU - Barbateskovic, Marija
AU - Lange, Theis
AU - Jensen, Aksel
AU - Krog, Martin B.
AU - Egerod, Ingrid
AU - Nibro, Helle L.
AU - Wetterslev, Jørn
AU - Perner, Anders
AU - Agrifoglio, A.
AU - Patruno, Adrianna
AU - Kalioubie, Ahmed El
AU - Lautrette, Alexandre
AU - Miguel, André
AU - Molinari, Andrea F.
AU - Toniolo, Anna
AU - Rodt, Anne P.
AU - Skafte, Anne At
AU - Nissen, Anne Kabell
AU - Naharro, Antonio
AU - Berg, Astrid Marie N.
AU - Estébanez,
AU - García, Belen
AU - Encina, Belen
AU - Bundgaard, Benedicte S.
AU - Rossen, Birgitte S.
AU - Sjoeboe, Brit Aa
AU - Díaz, Candido
AU - Bäckman, Carl
AU - Leggieri, Carlo
AU - de Cabo, Carlos Muñoz
AU - Pavo-Galán, Carmen
AU - Gutiérrez, Carola
AU - Tingsvik, Catarina
AU - Rousseau, Cécile
AU - Kjer, Cilia Klara Winther
AU - Almeida, Claudia
AU - Estrup, Stine
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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.
AB - 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.
KW - Cohort
KW - Critical care
KW - Delirium
KW - Haloperidol
KW - ICU
UR - http://www.scopus.com/inward/record.url?scp=85047170197&partnerID=8YFLogxK
U2 - 10.1007/s00134-018-5204-y
DO - 10.1007/s00134-018-5204-y
M3 - Article
C2 - 29767323
AN - SCOPUS:85047170197
SN - 0342-4642
VL - 44
SP - 1081
EP - 1089
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 7
ER -