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Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年1月3日

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  • Camilla Bekker Mortensen,
  • Nina Christine Andersen-Ranberg,
  • Lone Musaeus Poulsen,
  • Anders Granholm,
  • Bodil Steen Rasmussen,
  • Maj-Brit Nørregaard Kjær,
  • Theis Lange,
  • Bjørn H. Ebdrup,
  • Marie Oxenbøll Collet,
  • Anne Sofie Andreasen,
  • Morten Heiberg Bestle,
  • Bülent Uslu,
  • Helle Scharling Pedersen,
  • Louise Gramstrup Nielsen,
  • Johanna Hästbacka,
  • Troels Bek Jensen,
  • Kjeld Damgaard,
  • Trine Sommer,
  • Matthew Morgen,
  • Nilanjan Dey,
  • Guiseppe Citerio,
  • Stine Estrup,
  • Ingrid Egerod,
  • Karin Samuelson,
  • Anders Perner,
  • Ole Mathiesen

摘要

Purpose

We assessed long-term outcomes in acutely admitted adult patients with delirium treated in intensive care unit (ICU) with haloperidol versus placebo.

Methods

We conducted pre-planned analyses of 1-year outcomes in the Agents Intervening against Delirium in the ICU (AID-ICU) trial, including mortality and health-related quality of life (HRQoL) assessed by Euroqol (EQ) 5-dimension 5-level questionnaire (EQ-5D-5L) index values and EQ visual analogue scale (EQ VAS) (deceased patients were assigned the numeric value zero). Outcomes were analysed using logistic and linear regressions with bootstrapping and G-computation, all with adjustment for the stratification variables (site and delirium motor subtype) and multiple imputations for missing HRQoL values.

Results

At 1-year follow-up, we obtained vital status for 96.2% and HRQoL data for 83.3% of the 1000 randomised patients. One-year mortality was 224/501 (44.7%) in the haloperidol group versus 251/486 (51.6%) in the placebo group, with an adjusted absolute risk difference of − 6.4%-points (95% confidence interval [CI] − 12.8%-points to − 0.2%-points; P = 0.045). These results were largely consistent across the secondary analyses. For HRQoL, the adjusted mean differences were 0.04 (95% CI − 0.03 to 0.11; P = 0.091) for EQ-5D-5L-5L index values, and 3.3 (95% CI − 9.3 to 17.5; P = 0.142) for EQ VAS.

Conclusions

In acutely admitted adult ICU patients with delirium, haloperidol treatment reduced mortality at 1-year follow-up, but did not statistically significantly improve HRQoL.