Should we still monitor QTc duration in frail older patients on low-dose haloperidol? A prospective observational cohort study
| Autor: | Frits W. Prinzen, Machiel Smid, Audrey Merry, Fieke van Moorsel, Walther Sipers, Sylvain Ploux, Mark R. Hazebroek, Frank Körver, Pierre Bordachar, Marc Strik, Ellen Castro |
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| Přispěvatelé: | MUMC+: MA Med Staf Artsass Cardiologie (9), RS: Carim - H02 Cardiomyopathy, Cardiologie, RS: Carim - H06 Electro mechanics, RS: Carim - H08 Experimental atrial fibrillation |
| Rok vydání: | 2019 |
| Předmět: |
Male
Aging medicine.medical_specialty Frail Elderly frailty 030204 cardiovascular system & hematology QT interval older people 03 medical and health sciences Electrocardiography delirium 0302 clinical medicine Older patients INTERVAL PROLONGATION Internal medicine medicine Haloperidol DRUGS Humans Frail elderly cardiovascular diseases 030212 general & internal medicine Prospective Studies Aged RISK Aged 80 and over Framingham Risk Score business.industry ASSOCIATION General Medicine corrected QT interval Long QT Syndrome INTRAVENOUS-HALOPERIDOL Delirium Observational study Female Geriatrics and Gerontology medicine.symptom business ANTIPSYCHOTICS medicine.drug Cohort study Antipsychotic Agents |
| Zdroj: | Age and Ageing, 49(5), 829-836. Oxford University Press |
| ISSN: | 1468-2834 0002-0729 |
| Popis: | Background Haloperidol at high dosage is associated with QTc prolongation and polymorphic ventricular arrhythmia but the effects of low-dose haloperidol remain unknown. Objective To evaluate the effects of low-dose haloperidol on QTc-duration in frail hospitalized elderly patients with delirium. Methods A prospective observational study including hospitalized patients aged ≥70 years with Groningen Frailty Index-score > 3. We included 150 patients who received haloperidol and 150 age- and frailty-matched control patients. Serial ECG recordings were performed at hospital admission and during hospitalization. QT-interval was corrected according to Framingham (QTc). Patients were grouped according to baseline QTc in normal (nQTc), borderline (bQTc) or abnormal (aQTc). Primary outcome was change in QTc-duration between first and second ECG. Potentially dangerous QTc was defined as QTc >500 ms or an increase of >50 ms. Results Patients in the haloperidol group (48% male, mean age 85y, nQT n = 98, bQT n = 31, aQT n = 20) received an average dose of 1.5 mg haloperidol per 24 hours. QTc decreased in patients with borderline (mean − 15 ± 29 ms, P Conclusion A trend to QTc shortening was seen, especially in patients with borderline or abnormal QTc at baseline, regardless of haloperidol use. These findings suggest that ECG monitoring of frail elderly patients who receive low-dose haloperidol, may not be necessary. |
| Databáze: | OpenAIRE |
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