Browsing by Subject "Delirium"

Sort by: Order: Results:

Now showing items 1-3 of 3
  • Andersen-Ranberg, Nina; Poulsen, Lone M.; Perner, Anders; Hästbacka, Johanna; Morgan, Matthew P. G.; Citerio, Giuseppe; Oxenboll-Collet, Marie; Weber, Sven-Olaf; Andreasen, Anne Sofie; Bestle, Morten H.; Uslu, Bulent; Pedersen, Helle B. S.; Nielsen, Louise G.; Damgaard, Kjeld; Jensen, Troels B.; Sommer, Trine; Dey, Nilanjan; Mathiesen, Ole; Granholm, Anders (2022)
    Background Delirium is highly prevalent in the intensive care unit (ICU) and is associated with high morbidity and mortality. The antipsychotic haloperidol is the most frequently used agent to treat delirium although this is not supported by solid evidence. The agents intervening against delirium in the intensive care unit (AID-ICU) trial investigates the effects of haloperidol versus placebo for the treatment of delirium in adult ICU patients. Methods This protocol describes the secondary, pre-planned Bayesian analyses of the primary and secondary outcomes up to day 90 of the AID-ICU trial. We will use Bayesian linear regression models for all count outcomes and Bayesian logistic regression models for all dichotomous outcomes. We will adjust for stratification variables (site and delirium subtype) and use weakly informative priors supplemented with sensitivity analyses using sceptical priors. We will present results as absolute differences (mean differences and risk differences) and relative differences (ratios of means and relative risks). Posteriors will be summarised using median values as point estimates and percentile-based 95% credibility intervals. Probabilities of any benefit/harm, clinically important benefit/harm and clinically unimportant differences will be presented for all outcomes. Discussion The results of this secondary, pre-planned Bayesian analysis will complement the primary frequentist analysis of the AID-ICU trial and facilitate a nuanced and probabilistic interpretation of the trial results.
  • Roitto, Hanna-Maria; Aalto, Ulla Liisa; Söderling, Riikka; Laakkonen, Marja-Liisa; Öhman, Hanna (2020)
    Key summary pointsAim The aim of Delirium Cafe was to try a new learning method to increase awareness of delirium and improve delirium care in an acute hospital setting. Findings Delirium Cafe seems to be both feasible and applicable as a new interactive-learning method in postgraduate medical teaching. Message It is important to create opportunities of stimulating learning. Delirium Cafe is a good example of a model that is both creative and interactive. Purpose The aim of Delirium Cafe was to try a new learning method to increase awareness of delirium and improve delirium care in an acute hospital setting in Helsinki, Finland. Method World Cafe-an active learning method, with four facilitators and four stations covering important aspects of delirium recognition and management, was used. Results 22 junior doctors and 4 members of the senior staff participated in the event on 13th of March 2019, the World Delirium Awareness Day (WDAD). Nobody dropped out during the 1 h training. Feedback on the educational method was positive. Conclusion Delirium Cafe seems to be both feasible and applicable as a new interactive-learning method in postgraduate medical teaching.
  • AID-ICU Cohort Study Co-authors; Loisa, Pekka (2018)
    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. 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. 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. 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.