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01-07-2018 | Original

Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients: the multinational AID-ICU inception cohort study

Authors: Marie O. Collet, Jesús Caballero, Romain Sonneville, Fernando A. Bozza, Peter Nydahl, Anna Schandl, Hilden Wøien, Giuseppe Citerio, Mark van den Boogaard, Johanna Hästbacka, Matthias Haenggi, Kirsten Colpaert, Louise Rose, Marija Barbateskovic, Theis Lange, Aksel Jensen, Martin B. Krog, Ingrid Egerod, Helle L. Nibro, Jørn Wetterslev, Anders Perner, the AID-ICU cohort study co-authors

Published in: Intensive Care Medicine | Issue 7/2018

Abstract

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.

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Title: Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients: the multinational AID-ICU inception cohort study
Authors: Marie O. Collet
Jesús Caballero
Romain Sonneville
Fernando A. Bozza
Peter Nydahl
Anna Schandl
Hilden Wøien
Giuseppe Citerio
Mark van den Boogaard
Johanna Hästbacka
Matthias Haenggi
Kirsten Colpaert
Louise Rose
Marija Barbateskovic
Theis Lange
Aksel Jensen
Martin B. Krog
Ingrid Egerod
Helle L. Nibro
Jørn Wetterslev
Anders Perner
the AID-ICU cohort study co-authors
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 7/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5204-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients: the multinational AID-ICU inception cohort study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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