Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium
(2024) In Intensive Care Medicine 50(1). p.103-113- Abstract
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... (More)
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.
(Less)
- author
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Delirium, Health-related quality of life, ICU, Long-term outcomes, Mortality, Treatment
- in
- Intensive Care Medicine
- volume
- 50
- issue
- 1
- pages
- 11 pages
- publisher
- Springer
- external identifiers
-
- pmid:38170227
- scopus:85181235598
- ISSN
- 0342-4642
- DOI
- 10.1007/s00134-023-07282-7
- language
- English
- LU publication?
- yes
- id
- cecbe602-064f-45c2-89df-afe4c2f1ac17
- date added to LUP
- 2024-02-08 16:24:27
- date last changed
- 2024-04-24 22:59:36
@article{cecbe602-064f-45c2-89df-afe4c2f1ac17,
abstract = {{<p>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.</p>}},
author = {{Mortensen, Camilla Bekker and Andersen-Ranberg, Nina Christine and Poulsen, Lone Musaeus and Granholm, Anders and Rasmussen, Bodil Steen and Kjær, Maj Brit Nørregaard and Lange, Theis and Ebdrup, Bjørn H. and Collet, Marie Oxenbøll and Andreasen, Anne Sofie and Bestle, Morten Heiberg and Uslu, Bülent and Pedersen, Helle Scharling and Nielsen, Louise Gramstrup and Hästbacka, Johanna and Jensen, Troels Bek and Damgaard, Kjeld and Sommer, Trine and Morgen, Matthew and Dey, Nilanjan and Citerio, Guiseppe and Estrup, Stine and Egerod, Ingrid and Samuelson, Karin and Perner, Anders and Mathiesen, Ole}},
issn = {{0342-4642}},
keywords = {{Delirium; Health-related quality of life; ICU; Long-term outcomes; Mortality; Treatment}},
language = {{eng}},
number = {{1}},
pages = {{103--113}},
publisher = {{Springer}},
series = {{Intensive Care Medicine}},
title = {{Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium}},
url = {{http://dx.doi.org/10.1007/s00134-023-07282-7}},
doi = {{10.1007/s00134-023-07282-7}},
volume = {{50}},
year = {{2024}},
}