• Johannes Lambert, Joris Vermassen, Jan Fierens, Harlinde Peperstraete, Mirko Petrovic, and Kirsten Colpaert.
• Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B9000 Ghent, Belgium. Electronic address: johannes.lambert@ugent.be.
• J Crit Care. 2021 Feb 1; 61: 162-167.

PurposeDelirium in the intensive care unit (ICU) is often treated with haloperidol or atypical antipsychotics. Antipsychotic treatment can lead to severe adverse effects and excess mortality. After initiation in the ICU, patients are at risk of having their antipsychotics continued unnecessarily at ICU and hospital discharge. This study aims to determine the incidence of, and risk factors for antipsychotic continuation at hospital discharge after ICU delirium.MethodsThis retrospective observational study was performed in a tertiary care center. Adult patients who received antipsychotics for ICU delirium during 2016 were included. Data was extracted from patient records. After univariate testing, a multivariate binary logistic regression model was used to identify independent risk factors for antipsychotic continuation.ResultsA total of 196 patients were included, of which 104 (53.1%) and 41 (20.9%) had their antipsychotics continued at ICU and hospital discharge respectively. Medical ICU admission (odds ratio [95% confidence interval] 2.97 [1.37-6.41]) and quetiapine treatment (5.81 [1.63-20.83]) were independently associated with antipsychotic continuation at hospital discharge.ConclusionsApproximately one in five patients were discharged from the hospital with continued antipsychotics. Hospital policies should implement strategies for systematic antipsychotic tapering and better follow-up of antipsychotics at transitions of care.Copyright © 2020 Elsevier Inc. All rights reserved.

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