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

Research output: Contribution to journalJournal articleResearchpeer-review

  • 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
  • Lange, Theis
  • Jensen, Aksel Karl Georg
  • Martin B Krog
  • Egerod, Ingrid Eugenie
  • Helle L Nibro
  • Jørn Wetterslev
  • Perner, Anders
  • AID-ICU cohort study co-authors

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 languageEnglish
JournalIntensive Care Medicine
Issue number7
Pages (from-to)1081-1089
Number of pages9
Publication statusPublished - 2018

ID: 197811680