Haloperidol use is associated with lower hospital mortality in mechanically ventilated patients.
OBJECTIVE
To determine whether haloperidol use is associated with lower mortality in mechanically ventilated patients.


METHODS
Retrospective cohort analysis.


METHODS
A large tertiary care academic medical center.


METHODS
A total of 989 patients mechanically ventilated for >48 hrs.


RESULTS
We compared differences in hospital mortality between patients who received haloperidol within 2 days of initiation of mechanical ventilation and those who never received haloperidol. Despite similar baseline characteristics, patients treated with haloperidol had significantly lower hospital mortality compared with those who never received haloperidol (20.5% vs. 36.1%; p = .004). The lower associated mortality persisted after adjusting for age, comorbidity, severity of illness, degree of organ dysfunction, admitting diagnosis, and other potential confounders.


CONCLUSIONS
Haloperidol was associated with significantly lower hospital mortality. These findings could have enormous implications for critically ill patients. Because of their observational nature and the potential risks associated with haloperidol use, they require confirmation in a randomized, controlled trial before being applied to routine patient care.
Milbrandt
Eric B
EB
CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Kersten
Alexander
A
Kong
Lan
L
Weissfeld
Lisa A
LA
Clermont
Gilles
G
Fink
Mitchell P
MP
Angus
Derek C
DC
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D016292:Procedural Sedation; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003693:Delirium / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000401:mortality; D012121:Respiration, Artificial; D012189:Retrospective Studies; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000401:mortality
D014150:Antipsychotic Agents; D007155:Immunologic Factors; D006220:Haloperidol