• Cory B Weaver, Sandra L Kane-Gill, Scott R Gunn, Levent Kirisci, and Pamela L Smithburger.
• University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA.
• J Crit Care. 2017 Oct 1; 41: 234-239.

PurposeConflicting data exists on the efficacy of antipsychotics for treatment of intensive care unit (ICU) delirium. The purpose of this study was to compare time to delirium resolution for ICU patients who were managed with and without antipsychotics.Materials And MethodsThis retrospective cohort evaluation included patients admitted to 12 ICUs at 5 sites over 5 weeks diagnosed with delirium. The primary outcome was time to delirium resolution. Secondary outcomes included ICU length of stay (LOS), mortality, discharge disposition and delirium redevelopment. A Cox proportional hazards model explored the relationship between covariates including antipsychotics and time to delirium resolution.ResultsA total of 255 patients met inclusion criteria; 69 (27%) received antipsychotics. In the antipsychotic group, time to resolution of delirium was longer (Median: 36hours vs. 13hours, p<0.001) and ICU LOS was longer (Median: 5.9days vs. 3.8days, p=0.005), but there were no differences in mortality or discharge disposition. Patients who used antipsychotics (HR=0.512; 95% CI: 0.276-0.952) and received mechanical ventilation (HR=0.381; 95% CI: 0.217-0.669) had slower rate for time to delirium resolution.ConclusionsWhile the treatment of delirium with antipsychotics remains common, antipsychotics were not associated with a shorter time to resolution of delirium.Copyright © 2017 Elsevier Inc. All rights reserved.

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