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

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

doi:10.1007/s00134-023-07282-7

Cited by 10 publications

(1 citation statement)

References 50 publications

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“…It is associated with an increased risk of hospital-acquired infections, increased risk of falls, increased hospital length of stay, and increased cost of stay [5] , [6] , [7] , [8] , [9] , [10] , [11] . The development of delirium also has long-term consequences - following discharge from the hospital, patients who develop delirium have worse cognitive function scores, and this cognitive dysfunction can persist for many years [12] , [13] , [14] .…”

Section: Introductionmentioning

confidence: 99%

A Dual-Camera Eye-Tracking Platform for Rapid Real-Time Diagnosis of Acute Delirium: A Pilot Study

Al-Hindawi,

Vizcaychipi,

Demiris

2024

IEEE J. Transl. Eng. Health Med.

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Objective: Delirium, an acute confusional state, affects 20-80% of patients in Intensive Care Units (ICUs), one in three medically hospitalized patients, and up to 50% of all patients who have had surgery. Its development is associated with short-and long-term morbidity, and increased risk of death. Yet, we lack any rapid, objective, and automated method to diagnose delirium. Here, we detail the prospective deployment of a novel dual-camera contextual eye-tracking platform. We then use the data from this platform to contemporaneously classify delirium.Results: We recruited 42 patients, resulting in 210 (114 with delirium, 96 without) recordings of hospitalized patients in ICU across two centers, as part of a prospective multi-center feasibility pilot study. All recordings made with our platform were usable for analysis. We divided the collected data into training and validation cohorts based on the data originating center. We trained two Temporal Convolutional Network (TCN) models that can classify delirium using a pre-existing manual scoring system (Confusion Assessment Method in ICU (CAM-ICU)) as the training target. The first model uses eye movements only which achieves an Area Under the Receiver Operator Curve (AUROC) of 0.67 and a mean Average Precision (mAP) of 0.68. The second model uses the point of regard, the part of the scene the patient is looking at, and increases the AUROC to 0.76 and the mAP to 0.81. These models are the first to classify delirium using continuous non-invasive eye-tracking but will require further clinical prospective validation prior to use as a decision-support tool. Clinical impact: Eye-tracking is a biological signal that can be used to identify delirium in patients in ICU. The platform, alongside the trained neural networks, can automatically, objectively, and continuously classify delirium aiding in the early detection of the deteriorating patient. Future work is aimed at prospective evaluation and clinical translation.

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Section: Introductionmentioning

confidence: 99%

A Dual-Camera Eye-Tracking Platform for Rapid Real-Time Diagnosis of Acute Delirium: A Pilot Study

Al-Hindawi,

Vizcaychipi,

Demiris

2024

IEEE J. Transl. Eng. Health Med.

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How does haloperidol influence the long-term outcomes of delirium?

Devlin,

Duprey,

Girard

2024

Intensive Care Med

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Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia

Crescioli,

Nielsen,

Bunzel

et al. 2024

Intensive Care Med

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Purpose The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia. Methods We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values. Results We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66–1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0–80) versus 40 (0–75) (adjusted mean difference: 4.8; 98.6% CI − 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0–0.81) in the lower-oxygenation group versus 0.43 (0–0.79) ( p = 0.20) in the higher-oxygenation group, respectively. Conclusion Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-024-07613-2.

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

Cited by 10 publications

References 50 publications

A Dual-Camera Eye-Tracking Platform for Rapid Real-Time Diagnosis of Acute Delirium: A Pilot Study

A Dual-Camera Eye-Tracking Platform for Rapid Real-Time Diagnosis of Acute Delirium: A Pilot Study

How does haloperidol influence the long-term outcomes of delirium?

Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia

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