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

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; AID-ICU cohort study co-authors

doi:10.1007/s00134-018-5204-y

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

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 WetterslevAnders Perner, AID-ICU cohort study co-authors

27 Citations (Scopus)

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.

Original language	English
Journal	Intensive Care Medicine
Volume	44
Issue number	7
Pages (from-to)	1081-1089
Number of pages	9
ISSN	0342-4642
DOIs	https://doi.org/10.1007/s00134-018-5204-y
Publication status	Published - 1 Jul 2018

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Collet, M. O., Caballero, J., Sonneville, R., Bozza, F. A., 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. B., Egerod, I., Nibro, H. L., ... AID-ICU cohort study co-authors (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, 44(7), 1081-1089. https://doi.org/10.1007/s00134-018-5204-y

Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients : the multinational AID-ICU inception cohort study. / Collet, Marie O; Caballero, Jesús; Sonneville, Romain et al.

In: Intensive Care Medicine, Vol. 44, No. 7, 01.07.2018, p. 1081-1089.

Research output: Contribution to journal › Journal article › Research › peer-review

Collet, MO, Caballero, J, Sonneville, R, Bozza, FA, 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, MB, Egerod, I, Nibro, HL, Wetterslev, J, Perner, A & AID-ICU cohort study co-authors 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

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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",

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.",

author = "Collet, {Marie O} and Jes{\'u}s Caballero and Romain Sonneville and Bozza, {Fernando A} and Peter Nydahl and Anna Schandl and Hilden W{\o}ien and Giuseppe Citerio and {van den Boogaard}, Mark and Johanna H{\"a}stbacka and Matthias Haenggi and Kirsten Colpaert and Louise Rose and Marija Barbateskovic and Theis Lange and Aksel Jensen and Krog, {Martin B} and Ingrid Egerod and Nibro, {Helle L} and J{\o}rn Wetterslev and Anders Perner and {AID-ICU cohort study co-authors}",

year = "2018",

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doi = "10.1007/s00134-018-5204-y",

language = "English",

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pages = "1081--1089",

journal = "European Journal of Intensive Care Medicine",

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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 - 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 - AID-ICU cohort study co-authors

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.

U2 - 10.1007/s00134-018-5204-y

DO - 10.1007/s00134-018-5204-y

M3 - Journal article

C2 - 29767323

SN - 0935-1701

VL - 44

SP - 1081

EP - 1089

JO - European Journal of Intensive Care Medicine

JF - European Journal of Intensive Care Medicine

IS - 7

ER -

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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