Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial
Purposes The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients. Methods A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2017-07, Vol.47 (7), p.815-826 |
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| container_title | Surgery today (Tokyo, Japan) |
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| creator | Fukata, Shinji Kawabata, Yasuji Fujishiro, Ken Kitagawa, Yuichi Kuroiwa, Kojiro Akiyama, Hirotoshi Takemura, Marie Ando, Masahiko Hattori, Hideyuki |
| description | Purposes
The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients.
Methods
A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (
n
= 101) received prophylactic haloperidol (5 mg); the control group (
n
= 100) did not. Haloperidol was administered daily during postoperative days 0–5 to the patients who presented with NEECHAM scores of 20–24 when measured at 18:00. The primary endpoint was the incidence of severe postoperative delirium.
Results
The incidence of severe postoperative delirium in all patients was 25.1%. The incidence of severe postoperative delirium in the intervention group (18.2%) was significantly lower than that in the control group (32.0%) (
p
= 0.02). The difference between the two groups was larger when the analysis was limited to the 70 patients who had NEECHAM scores of 20–24 for at least one day during postoperative days 0–5. No adverse effects of the haloperidol were observed.
Conclusion
The prophylactic administration of haloperidol at the early stage of delirium significantly reduced the incidence of severe postoperative delirium in elderly patients.
Clinical Trial Registration
UMIN000007204. |
| doi_str_mv | 10.1007/s00595-016-1441-2 |
| format | Article |
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The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients.
Methods
A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (
n
= 101) received prophylactic haloperidol (5 mg); the control group (
n
= 100) did not. Haloperidol was administered daily during postoperative days 0–5 to the patients who presented with NEECHAM scores of 20–24 when measured at 18:00. The primary endpoint was the incidence of severe postoperative delirium.
Results
The incidence of severe postoperative delirium in all patients was 25.1%. The incidence of severe postoperative delirium in the intervention group (18.2%) was significantly lower than that in the control group (32.0%) (
p
= 0.02). The difference between the two groups was larger when the analysis was limited to the 70 patients who had NEECHAM scores of 20–24 for at least one day during postoperative days 0–5. No adverse effects of the haloperidol were observed.
Conclusion
The prophylactic administration of haloperidol at the early stage of delirium significantly reduced the incidence of severe postoperative delirium in elderly patients.
Clinical Trial Registration
UMIN000007204.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-016-1441-2</identifier><identifier>PMID: 27830365</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Aged, 80 and over ; Antipsychotic Agents - administration & dosage ; Delirium - epidemiology ; Delirium - prevention & control ; Elective Surgical Procedures ; Female ; Haloperidol - administration & dosage ; Humans ; Incidence ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Postoperative Care ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; Postoperative Period ; Prospective Studies ; Severity of Illness Index ; Surgery ; Surgical Oncology ; Treatment Outcome</subject><ispartof>Surgery today (Tokyo, Japan), 2017-07, Vol.47 (7), p.815-826</ispartof><rights>Springer Japan 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-65b1d9db237884953991358e8bb718997e3d8975f2ccc18723cc9b79c01c65cf3</citedby><cites>FETCH-LOGICAL-c434t-65b1d9db237884953991358e8bb718997e3d8975f2ccc18723cc9b79c01c65cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-016-1441-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-016-1441-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27830365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fukata, Shinji</creatorcontrib><creatorcontrib>Kawabata, Yasuji</creatorcontrib><creatorcontrib>Fujishiro, Ken</creatorcontrib><creatorcontrib>Kitagawa, Yuichi</creatorcontrib><creatorcontrib>Kuroiwa, Kojiro</creatorcontrib><creatorcontrib>Akiyama, Hirotoshi</creatorcontrib><creatorcontrib>Takemura, Marie</creatorcontrib><creatorcontrib>Ando, Masahiko</creatorcontrib><creatorcontrib>Hattori, Hideyuki</creatorcontrib><title>Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purposes
The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients.
Methods
A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (
n
= 101) received prophylactic haloperidol (5 mg); the control group (
n
= 100) did not. Haloperidol was administered daily during postoperative days 0–5 to the patients who presented with NEECHAM scores of 20–24 when measured at 18:00. The primary endpoint was the incidence of severe postoperative delirium.
Results
The incidence of severe postoperative delirium in all patients was 25.1%. The incidence of severe postoperative delirium in the intervention group (18.2%) was significantly lower than that in the control group (32.0%) (
p
= 0.02). The difference between the two groups was larger when the analysis was limited to the 70 patients who had NEECHAM scores of 20–24 for at least one day during postoperative days 0–5. No adverse effects of the haloperidol were observed.
Conclusion
The prophylactic administration of haloperidol at the early stage of delirium significantly reduced the incidence of severe postoperative delirium in elderly patients.
Clinical Trial Registration
UMIN000007204.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antipsychotic Agents - administration & dosage</subject><subject>Delirium - epidemiology</subject><subject>Delirium - prevention & control</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>Haloperidol - administration & dosage</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Postoperative Care</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Postoperative Period</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Treatment Outcome</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGOFCEQhonRuOPqA3gxHD3YSkF3A97MRl2TTbzomdBQPbKhmxa6Jzs-gw8ts7N69ESo-r-_Cn5CXgJ7C4zJd4WxTncNg76BtoWGPyI7aEXfcAXiMdkxXYvANVyQZ6XcMsZbxdhTcsGlEkz03Y78vrYxLZiDT5EuOS0_jtHehULHlOsdDzivYd5Tu99ne7BrSDNNI11SWU9YLRyQeowhh22iYaYYPeZ4pEttVba8p5ZmO_s0hV_o39BKzU20A96PKwu6e4s1BxufkyejjQVfPJyX5Punj9-urpubr5-_XH24aVwr2rXpuwG89gMXUqlWd0JrEJ1CNQwSlNYShVdadiN3zoGSXDinB6kdA9d3bhSX5PXZt27wc8OymikUhzHaGdNWDCihgWnZqiqFs9TVZUvG0Sw5TDYfDTBzCsGcQzA1BHMKwfDKvHqw34YJ_T_i769XAT8LSm3Ne8zmNm15rk_-j-sfbkCVSw</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Fukata, Shinji</creator><creator>Kawabata, Yasuji</creator><creator>Fujishiro, Ken</creator><creator>Kitagawa, Yuichi</creator><creator>Kuroiwa, Kojiro</creator><creator>Akiyama, Hirotoshi</creator><creator>Takemura, Marie</creator><creator>Ando, Masahiko</creator><creator>Hattori, Hideyuki</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial</title><author>Fukata, Shinji ; Kawabata, Yasuji ; Fujishiro, Ken ; Kitagawa, Yuichi ; Kuroiwa, Kojiro ; Akiyama, Hirotoshi ; Takemura, Marie ; Ando, Masahiko ; Hattori, Hideyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-65b1d9db237884953991358e8bb718997e3d8975f2ccc18723cc9b79c01c65cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antipsychotic Agents - administration & dosage</topic><topic>Delirium - epidemiology</topic><topic>Delirium - prevention & control</topic><topic>Elective Surgical Procedures</topic><topic>Female</topic><topic>Haloperidol - administration & dosage</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Postoperative Care</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Postoperative Period</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukata, Shinji</creatorcontrib><creatorcontrib>Kawabata, Yasuji</creatorcontrib><creatorcontrib>Fujishiro, Ken</creatorcontrib><creatorcontrib>Kitagawa, Yuichi</creatorcontrib><creatorcontrib>Kuroiwa, Kojiro</creatorcontrib><creatorcontrib>Akiyama, Hirotoshi</creatorcontrib><creatorcontrib>Takemura, Marie</creatorcontrib><creatorcontrib>Ando, Masahiko</creatorcontrib><creatorcontrib>Hattori, Hideyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukata, Shinji</au><au>Kawabata, Yasuji</au><au>Fujishiro, Ken</au><au>Kitagawa, Yuichi</au><au>Kuroiwa, Kojiro</au><au>Akiyama, Hirotoshi</au><au>Takemura, Marie</au><au>Ando, Masahiko</au><au>Hattori, Hideyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>47</volume><issue>7</issue><spage>815</spage><epage>826</epage><pages>815-826</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purposes
The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients.
Methods
A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (
n
= 101) received prophylactic haloperidol (5 mg); the control group (
n
= 100) did not. Haloperidol was administered daily during postoperative days 0–5 to the patients who presented with NEECHAM scores of 20–24 when measured at 18:00. The primary endpoint was the incidence of severe postoperative delirium.
Results
The incidence of severe postoperative delirium in all patients was 25.1%. The incidence of severe postoperative delirium in the intervention group (18.2%) was significantly lower than that in the control group (32.0%) (
p
= 0.02). The difference between the two groups was larger when the analysis was limited to the 70 patients who had NEECHAM scores of 20–24 for at least one day during postoperative days 0–5. No adverse effects of the haloperidol were observed.
Conclusion
The prophylactic administration of haloperidol at the early stage of delirium significantly reduced the incidence of severe postoperative delirium in elderly patients.
Clinical Trial Registration
UMIN000007204.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>27830365</pmid><doi>10.1007/s00595-016-1441-2</doi><tpages>12</tpages></addata></record> |
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| identifier | ISSN: 0941-1291 |
| ispartof | Surgery today (Tokyo, Japan), 2017-07, Vol.47 (7), p.815-826 |
| issn | 0941-1291 1436-2813 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Antipsychotic Agents - administration & dosage Delirium - epidemiology Delirium - prevention & control Elective Surgical Procedures Female Haloperidol - administration & dosage Humans Incidence Male Medicine Medicine & Public Health Original Article Postoperative Care Postoperative Complications - epidemiology Postoperative Complications - prevention & control Postoperative Period Prospective Studies Severity of Illness Index Surgery Surgical Oncology Treatment Outcome |
| title | Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial |
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