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Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial

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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.

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Acknowledgements

This work was supported by Research Funding for Longevity Sciences (23-28, 26-10) from the National Center for Geriatrics and Gerontology (NCGG), Japan.

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Authors and Affiliations

  1. Department of Surgery, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan

    Shinji Fukata, Yasuji Kawabata, Ken Fujishiro & Yuichi Kitagawa

  2. Department of Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakaecho, Itabasi-ku, Tokyo, 173-0015, Japan

    Kojiro Kuroiwa

  3. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Hirotoshi Akiyama

  4. Department of Orthopedics, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan

    Marie Takemura

  5. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Turumai, Shouwa-ku, Nagoya, 466-8560, Japan

    Masahiko Ando

  6. Department of Psychiatry, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan

    Hideyuki Hattori

  7. Department of Perioperative Medical Care, National Center Hospital for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan

    Shinji Fukata

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  1. Shinji Fukata
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Correspondence to Shinji Fukata.

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Fukata, S., Kawabata, Y., Fujishiro, K. et al. Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: a randomized, open-label prospective trial. Surg Today 47, 815–826 (2017). https://doi.org/10.1007/s00595-016-1441-2

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