1. Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients:the multinational AID-ICU inception cohort study
- Author
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Theis Lange, Jørn Wetterslev, Jesús Caballero, Ingrid Egerod, Johanna Hästbacka, Anders Perner, Hilden Wøien, Louise Rose, Marie Oxenbøll Collet, Matthias Haenggi, Mark van den Boogaard, Kirsten Colpaert, Giuseppe Citerio, Anna Schandl, Romain Sonneville, Marija Barbateskovic, Martin B. Krog, Aksel Karl Georg Jensen, Fernando A. Bozza, Helle Lykkeskov Nibro, Peter Nydahl, Department of Diagnostics and Therapeutics, Clinicum, Anestesiologian yksikkö, University of Helsinki, HYKS erva, HUS Perioperative, Intensive Care and Pain Medicine, Collet, M, Caballero, J, Sonneville, R, Bozza, F, Nydahl, P, Schandl, A, Wøien, H, Citerio, G, van den Boogaard, M, Hästbacka, J, Haenggi, M, Colpaert, K, Rose, L, Barbateskovic, M, Lange, T, Jensen, A, Krog, M, Egerod, I, Nibro, H, Wetterslev, J, and Perner, A
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TERM COGNITIVE IMPAIRMENT ,Olanzapine ,LEVEL ,Cohort ,Critical care ,Delirium ,Haloperidol ,ICU ,Adolescent ,Adult ,Brazil ,Canada ,Critical Care ,Europe ,Humans ,Intensive Care Units ,Prevalence ,Prospective Studies ,Risk Factors ,Antipsychotic Agents ,MULTICENTER ,GUIDELINES ,Critical Care and Intensive Care Medicine ,0302 clinical medicine ,030212 general & internal medicine ,Prospective cohort study ,CAM-ICU ,SEDATION SCALE ,3. Good health ,medicine.symptom ,CRITICALLY-ILL PATIENTS ,medicine.drug ,medicine.medical_specialty ,MECHANICALLY VENTILATED PATIENTS ,610 Medicine & health ,behavioral disciplines and activities ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Intensive care ,Internal medicine ,medicine ,Dexmedetomidine ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,030208 emergency & critical care medicine ,Odds ratio ,3126 Surgery, anesthesiology, intensive care, radiology ,UNIT ,Quetiapine ,CRITICAL ILLNESS ,business - Abstract
PurposeWe 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.MethodsAll 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.ResultsWe 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.ConclusionsIn 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.
- Published
- 2018