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

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AID-ICU Cohort Study Co-authors & Loisa , P 2018 , ' Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients : the multinational AID-ICU inception cohort study ' , Intensive Care Medicine , vol. 44 , no. 7 , pp. 1081-1089 . https://doi.org/10.1007/s00134-018-5204-y

Title: Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients : the multinational AID-ICU inception cohort study
Author: AID-ICU Cohort Study Co-authors; Loisa, Pekka
Contributor: University of Helsinki, HYKS erva
Date: 2018-07
Language: eng
Number of pages: 9
Belongs to series: Intensive Care Medicine
ISSN: 0342-4642
URI: http://hdl.handle.net/10138/304162
Abstract: 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.
Subject: Delirium
ICU
Haloperidol
Cohort
Critical care
CRITICALLY-ILL PATIENTS
MECHANICALLY VENTILATED PATIENTS
TERM COGNITIVE IMPAIRMENT
CRITICAL ILLNESS
SEDATION SCALE
CAM-ICU
UNIT
GUIDELINES
LEVEL
MULTICENTER
3126 Surgery, anesthesiology, intensive care, radiology
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