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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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.
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Hyperactive delirium most often comes to clinical attention, but the mixed and hypoactive presentations are far more common.
“Hyperactive delirium most often comes to clinical attention, but the mixed and hypoactive presentations are far more common [7,59,60,61].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [60]
The Background says mixed and hypoactive delirium are more common than hyperactive delirium, and the Delirium results report 13.1% mixed and 5.7% hypoactive versus 6.1% hyperactive among ICU patients. The paper does not establish that hyperactive delirium most often comes to clinical attention. (LLM, conf=0.86)
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References 45 · Cited by 114
- Authors
- 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., Wetterslev, J., Perner, A., co-authors, T. A.-I. C. S., Agrifoglio, A., Patruno, A., Kalioubie, A. E., Lautrette, A., Miguel, A., Molinari, A. F., Toniolo, A., Rodt, A. P., Skafte, A. A., Nissen, A. K., Naharro, A., Berg, A. M. N., Estébanez, García, B., Encina, B., Bundgaard, B. S., Rossen, B. S., Sjoeboe, B. A., Díaz, C., Bäckman, C., Leggieri, C., de Cabo, C. M., Pavo-Galán, C., Gutiérrez, C., Tingsvik, C., Rousseau, C., Kjer, C. K. W., Almeida, C., Cantaroni, C., de Oliveira, C. C., Escudero, Pretorius, D., Hees, D., Manzanedo, D., Mamaev, D., Christensen, D., Skorstad, E. M., Lappi, E., Wiborg, E., Siven, E., Perecmanis, E., Sauter, E., De Lucas, E. H., Cabeza, E. F., Aakerman, E., Lovisari, F., Vagginelli, F., Näsström, F., Schiöler, F., Moreno-Gonzalez, G., Martelli, G., Gimeno, G., Tanaskovic, G., Ramos, G. V., Abusdal, G., Aagaard, G., Jensen, H. I., Knudsen, H., Bundgaard, H., Hoffmeyer, H., Torrado, H., Aguirre-Bermeo, H., Pérez-Moltó, H., Jara, de Haas, I., Baerentsen, I. D., Finnstroem, I. J., Greve, I. E., Ceniceros, I., Savia, I., Astola, I., Elkjaer, J. M., Mira, J.-P., Palm, J. L., Soini, J., Olsson, J. E., Nyberg, J., Heinonen, J., Alonso, J., García, J. M. G., Masclans, Jr., Goyeneche, J. M., Corral, J. M., Pilypaite, J., Bye, K., Saarinen, K., Wian, K.-A., Weber, K., Donadello, K., Kangas, K., Simons, K. S., Lundholm, L., Malchiodi, L., Álvarez, L., Han-Byul, L., Rabello, L. S. C. F., von Holck, L., Loisa, P., Buus, L., Christensen, L. J., Dall’ara, L., Melkersson, L., Orwelius, L., De Crop, L., Antoine, M., Santafé, M., Sánchez, M., Blackwell, M. L., Cronhjort, M., Martínez, M., Martín-Delgado, M. C., Levin, M., Maus, M., Henry-Lagarrigue, M., Romera, M. A., Välimäki, M., Bernal, M. H., Ramon, N., Baeza, N., Maquigneau, N., Marin, N., Moeller-Nielsen, N., Terzi, N., Glerup, O., Vinorum, O., Inkinen, O., Hild, P., Miquel-Diego, P., Rood, P., de Azambuja Rodrigues, P. M., Ernoe, P. E., Baadstoeloekken, P. M., Holm, P., Haltia, P., Ferrer, R., Hansen, R., Yano, R., Medici, R., da Silva, R. T. A., Smonig, R., Frederiksen, R., Sardo, S., Sutinen, S., Kentala, S., Besset, S., Sant’Anna, S. T., Rodríguez, S., Zambelli, S. E., Contreras, S., Pedersen, S., Hüfner, S., Leggio, S., Balsliemke, S., Gaudry, S., Estrup, S., Temprano, S., Nielsen, S., van Zuylen, T., Suhonen, T., Melms, T., Heinicke, T., Zinzoni, V., Blázquez-Alcaide, V., Jørgensen, V. L., & Collado, Z.
- Affiliations
- Copenhagen University Hospital (DK)
- Universitat Autònoma de Barcelona (ES)
- Inserm (FR)
- Ministério da Saúde (BR)
- University Hospital Schleswig-Holstein (DE)
- Karolinska University Hospital (SE)
- Oslo University Hospital (NO)
- University of Milano-Bicocca (IT)
- University of Helsinki (FI)
- Ghent University Hospital (BE)
- Sunnybrook Health Science Centre (CA)
- University of Copenhagen (DK)
- Aarhus University Hospital (DK)
- Corresponding author
- Collet, Marie O.
- ORCID
- Collet, Marie O.
- Caballero, Jesús
- Sonneville, Romain
- Bozza, Fernando A.
- Nydahl, Peter
- Schandl, Anna
- Citerio, Giuseppe
- Hästbacka, Johanna
- Colpaert, Kirsten
- Rose, Louise
- Barbateskovic, Marija
- Lange, Theis
- Jensen, Aksel
- Egerod, Ingrid
- Wetterslev, Jørn
- Perner, Anders
- Agrifoglio, A.
- Lautrette, Alexandre
- Martelli, Gabriele
- Mira, Jean-Paul
- Donadello, Katia
- Terzi, Nicolas
- Rood, Paul
- Ferrer, R.
- Sardo, Salvatore
- Estrup, Stine
- Venue
- Intensive Care Medicine
- Published
- 2018-05-16
- Volume
- 44
- Issue
- 7
- Pages
- 1081-1089
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2803806834
- Cited by
- 114
- References
- 45
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 11 · 2023: 36 · 2022: 9 · 2021: 14 · 2020: 7 · 2019: 17 · 2018: 3
- FWCI
- 8.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Arca - Repositório Institucional da Fiocruz (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Työväentutkimus Vuosikirja (submittedVersion, other-oa)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Open Access CRIS of the University of Bern
- Funders
- Innovation Foundation Denmark
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- haloperidol, delirium, intensive care unit patients, delirium prevalence, delirium risk factors, 90-day mortality, benzodiazepines, dexmedetomidine, quetiapine, olanzapine, delirium subtypes, circulatory support, antipsychotic use
- MeSH terms
- Adolescent, Adult, Brazil, Canada, Critical Care, Delirium, Europe, Haloperidol, Humans, Intensive Care Units, Prospective Studies, Risk Factors, Antipsychotic Agents, Prevalence
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