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In-Hospital Haloperidol Use and Perioperative Changes in QTc-Duration

Blom, M. T., de Jonghe, A., van Munster, B. C., de Rooij, S. E., Tan, H. L., van der Velde, N. & Jansen, S., 2015, In : The Journal of Nutrition, Health & Aging. 19, 5, p. 583-9 7 p.

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  • In-hospital haloperidol use and perioperative changes in QTc-duration

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DOI

OBJECTIVES: Haloperidol may prolong ECG QTc-duration but is often prescribed perioperatively to hip-fracture patients. We aimed to determine (1) how QTc-duration changes perioperatively, (2) whether low-dose haloperidol-use influences these changes, and (3) which clinical variables are associated with potentially dangerous perioperative QTc-prolongation (PD-QTc; increase >50 ms or to >500 ms).

DESIGN: Prospective cohort study.

SETTING: Tertiary university teaching-hospital.

PARTICIPANTS: Patients enrolled in a randomized controlled clinical trial of melatonin versus placebo on occurrence of delirium in hip-fracture patients.

MEASUREMENTS: Data from ECGs made before and after hip surgery (1-3 days and/or 4-6 days post-surgery) were analyzed. QTc-duration was measured by hand, blinded for haloperidol and pre/post-surgery status. Clinical variables were measured at baseline. Mixed model analysis was used to estimate changes in QTc-duration. Risk-factors for PD-QTc were estimated by logistic regression analysis.

RESULTS: We included 89 patients (mean age 84 years, 24% male); 39 were treated with haloperidol. Patients with normal pre-surgery QTc-duration (male ≤430 ms, female ≤450 ms) had a significant increase (mean 12 ms, SD 28) in QTc-duration. A significant decrease (mean 19 ms, SD 34) occurred in patients with prolonged pre-surgery QTc-duration (male >450ms, female >470 ms). Haloperidol-use did not influence the perioperative course of the QTc-interval (p=0.351). PD-QTc (n=8) was not associated with any of the measured risk-factors.

CONCLUSION: QTc-duration changed differentially, increasing in patients with normal, but decreasing in patients with abnormal baseline QTc-duration. PD-QTc was not associated with haloperidol-use or other risk-factors. Low-dose oral haloperidol did not affect perioperative QTc-interval.

Original languageEnglish
Pages (from-to)583-9
Number of pages7
JournalThe Journal of Nutrition, Health & Aging
Volume19
Issue number5
Publication statusPublished - 2015
Externally publishedYes

    Keywords

  • Aged, 80 and over, Antipsychotic Agents, Cohort Studies, Delirium, Electrocardiography, Female, Haloperidol, Hip Fractures, Hospitals, Humans, Male, Melatonin, Perioperative Period, Prospective Studies, Risk Factors, Single-Blind Method, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't

ID: 34345610