Association of Cumulative Dose of Haloperidol With Next-Day Delirium in Older Medical ICU Patients

被引:20
|
作者
Pisani, Margaret A. [1 ,2 ]
Araujo, Katy L. B. [2 ,3 ]
Murphy, Terrence E. [2 ,3 ]
机构
[1] Yale Univ, Sch Med, Dept Med, Pulm & Crit Care Sect, New Haven, CT 06510 USA
[2] Yale Univ, Sch Med, Program Aging, New Haven, CT USA
[3] Yale Univ, Sch Med, Dept Med, Geriatr Sect, New Haven, CT 06510 USA
基金
美国国家卫生研究院;
关键词
delirium; geriatric; haloperidol; marginal structural model; time-dependent confounding; INTENSIVE-CARE-UNIT; MORTALITY; DURATION; BENZODIAZEPINE; IMPACT;
D O I
10.1097/CCM.0000000000000863
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: To evaluate the association between cumulative dose of haloperidol and next-day diagnosis of delirium in a cohort of older medical ICU patients, with adjustment for its time-dependent confounding with fentanyl and intubation. Design: Prospective, observational study. Setting: Medical ICU at an urban, academic medical center. Patients: Age 60 years and older admitted to the medical ICU who received at least one dose of haloperidol (n = 93). Of these, 72 patients were intubated at some point in their medical ICU stay, whereas 21 were never intubated. Interventions: None. Measurements and Main Results: Detailed data were collected concerning time, dosage, route of administration of all medications, as well as for important clinical covariates, and daily status of intubation and delirium using the confusion assessment method for the ICU and a chart-based algorithm. Among nonintubated patients, and after adjustment for time-dependent confounding and important covariates, each additional cumulative milligram of haloperidol was associated with 5% higher odds of next-day delirium with odds ratio of 1.05 (credible interval [CI], 1.02-1.09). After adjustment for time-dependent confounding and covariates, intubation was associated with a five-fold increase in odds of next-day delirium with odds ratio of 5.66 (CI, 2.70-12.02). Cumulative dose of haloperidol among intubated patients did not change their already high likelihood of next-day delirium. After adjustment for time-dependent confounding, the positive associations between indicators of intubation and of cognitive impairment and next-day delirium became stronger. Conclusions: These results emphasize the need for more studies regarding the efficacy of haloperidol for treatment of delirium among older medical ICU patients and demonstrate the value of assessing nonintubated patients.
引用
收藏
页码:996 / 1002
页数:7
相关论文
共 50 条
  • [1] Haloperidol for the Treatment of Delirium in ICU Patients
    Andersen-Ranberg, Nina C.
    Poulsen, Lone M.
    Perner, Anders
    Wetterslev, Jorn
    Estrup, Stine
    Haestbacka, Johanna
    Morgan, Matt
    Citerio, Giuseppe
    Caballero, Jesus
    Lange, Theis
    Kjaer, Maj-Brit N.
    Ebdrup, Bjorn H.
    Engstrom, Janus
    Olsen, Markus H.
    Oxenboll Collet, Marie
    Mortensen, Camilla B.
    Weber, Sven-Olaf
    Andreasen, A. Sofie
    Bestle, Morten H.
    Uslu, Buelent
    Scharling Pedersen, Helle
    Gramstrup Nielsen, Louise
    Toft Boesen, Hans C.
    Jensen, Jacob V.
    Nebrich, Lars
    La Cour, Kirstine
    Laigaard, Jens
    Haurum, Cecilie
    Olesen, Marie W.
    Overgaard-Steensen, Christian
    Westergaard, Bo
    Brand, Bjorn A.
    Kingo Vesterlund, Gitte
    Thornberg Kyhnauv, Pernille
    Mikkelsen, Vibe S.
    Hyttel-Sorensen, Simon
    de Haas, Inge
    Aagaard, Soren R.
    Nielsen, Line O.
    Eriksen, Anne S.
    Rasmussen, Bodil S.
    Brix, Helene
    Hildebrandt, Thomas
    Schonemann-Lund, Martin
    Fjeldsoe-Nielsen, Hans
    Kuivalainen, Anna-Maria
    Mathiesen, Ole
    AID ICU Trial Grp
    NEW ENGLAND JOURNAL OF MEDICINE, 2022, 387 (26): : 2425 - 2435
  • [2] Haloperidol for the Treatment of Delirium in ICU Patients
    Cruz, Dulce M.
    JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2023, 65 (05) : 469 - 470
  • [3] Statin and Its Association With Delirium in the Medical ICU
    Mather, Jeffrey F.
    Corradi, John P.
    Waszynski, Christine
    Noyes, Adam
    Duan, Yinghui
    Grady, James
    Dicks, Robert
    CRITICAL CARE MEDICINE, 2017, 45 (09) : 1515 - 1522
  • [4] ASSOCIATION OF CUMULATIVE HALOPERIDOL DOSE WITH 28-AND 90-DAY MORTALITY IN CRITICALLY ILL ADULTS
    Duprey, Matthew
    van den Boogaard, Mark
    Van der Hoeven, Johannes
    Pickkers, Peter
    Briesacher, Becky
    Saczynski, Jane
    Griffith, John
    Devlin, John
    CRITICAL CARE MEDICINE, 2020, 48
  • [5] Comparison of Ketamine to Haloperidol for Preventing Delirium in ICU Elderly Patients
    Hosseindoost, Saereh
    Zabetpoor, Mohammad Javad
    Ghazi, Samrand Fattah
    Orandi, Amirhossein
    Pestei, Khalil
    ARCHIVES OF NEUROSCIENCE, 2023, 10 (04)
  • [6] Association between prior-night sleep and next-day fatigue in older adults: a daily diary study
    Nakagawa, Takeshi
    Yasumoto, Saori
    Kabayama, Mai
    Matsuda, Ken'ichi
    Gondo, Yasuyuki
    Kamide, Kei
    Ikebe, Kazunori
    BMC GERIATRICS, 2023, 23 (01)
  • [7] Association between prior-night sleep and next-day fatigue in older adults: a daily diary study
    Takeshi Nakagawa
    Saori Yasumoto
    Mai Kabayama
    Ken’ichi Matsuda
    Yasuyuki Gondo
    Kei Kamide
    Kazunori Ikebe
    BMC Geriatrics, 23
  • [8] Sleep disturbance and next-day physical activity in COPD patients
    Kim, Inah
    Kapella, Mary C.
    Collins, Eileen G.
    Bronas, Ulf G.
    Horswill, Craig A.
    Park, Chang
    Quinn, Laurie
    GERIATRIC NURSING, 2020, 41 (06) : 872 - 877
  • [9] Comparing Dexmedetomidine With Haloperidol for the Treatment of Hyperactive Delirium in Nonintubated ICU Patients
    Dotson, Bryan
    CRITICAL CARE MEDICINE, 2016, 44 (12) : E1259 - E1260
  • [10] DAILY PREDICTION OF NEXT-DAY DISEASE SEVERITY IN CRITICALLY ILL PATIENTS
    Zhang, Wenbo
    Cox, Eline
    Heijkoop, Emese
    Klaver, Manon
    van der Voort, Peter
    Snieder, Harold
    Keus, Eric
    Lunter, Gerton
    CRITICAL CARE MEDICINE, 2024, 52