Evidence map›Paper›PMID 30460981›Full record

Trial reportJournal of the American Geriatrics Society2018

Preventing Postoperative Delirium After Major Noncardiac Thoracic Surgery-A Randomized Clinical Trial.

Babar A Khan, Anthony J Perkins, Noll L Campbell, Sujuan Gao, Sikandar H Khan, Sophia Wang, Mikita Fuchita, Daniel J Weber, Ben L Zarzaur, Malaz A Boustani and 1 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 6 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 6 syntheses or guidelines pooled it, 45 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Effect of Delirium on Physical Function in Noncardiac Thoracic Surgery Patients.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2020
    Trial
  9. Trial
  10. Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Ramelteon and suvorexant for postoperative delirium in elderly patients with esophageal cancer.Esophagus : official journal of the Japan Esophageal Society · 2023
    Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Babar A KhanDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.ORCID 0000-0003-4507-6968
Anthony J PerkinsDepartment of Statistics, School of Medicine, Indiana University, Indianapolis, Indiana.
Noll L CampbellDepartment of Medicine, Center for Aging Research, Indiana University, Indianapolis, Indiana.
Sujuan GaoDepartment of Statistics, School of Medicine, Indiana University, Indianapolis, Indiana.
Sikandar H KhanDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.
Sophia WangDepartment of Psychiatry, School of Medicine, Indiana University, Indianapolis, Indiana.
Mikita FuchitaDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.
Daniel J WeberDepartment of Surgery, University of California, San Francisco, San Francisco, California.
Ben L ZarzaurDepartment of Surgery, School of Medicine, Indiana University, Indianapolis, Indiana.
Malaz A BoustaniDepartment of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.
Kenneth KeslerDepartment of Surgery, School of Medicine, Indiana University, Indianapolis, Indiana.
Indiana University – Purdue University Indianapolis · USRegenstrief Institute · USUniversity of California, San Francisco · US

Funding

Reactive Oxygen Species in Respiratory Failure, Delirium, and Post-ICU Cognitive ImpairmentK76AG074925 · NIA · INDIANA UNIVERSITY INDIANAPOLIS · PI Sikandar Hayat Khan · 2022 to 2026
$1.1M
Delirium Biomarkers in the Intensive Care UnitK23AG043476 · NIA · INDIANA UNIVERSITY INDIANAPOLIS · PI KHAN, BABAR A · 2012 to 2016
$629k
NIA NIH HHS K23 AG043476NIA NIH HHS K76 AG074925
6 · The paper itself

Abstract

objectivesTo assess the efficacy of haloperidol in reducing postoperative delirium in individuals undergoing thoracic surgery.

designRandomized double-blind placebo-controlled trial.

settingSurgical intensive care unit (ICU) of tertiary care center.

participantsIndividuals undergoing thoracic surgery (N=135).

interventionLow-dose intravenous haloperidol (0.5 mg three times daily for a total of 11 doses) administered postoperatively. MEASUREMENTS: The primary outcome was delirium incidence during hospitalization. Secondary outcomes were time to delirium, delirium duration, delirium severity, and ICU and hospital length of stay. Delirium was assessed using the Confusion Assessment Method for the ICU and delirium severity using the Delirium Rating Scale-Revised.

resultsSixty-eight participants were randomized to receive haloperidol and 67 placebo. No significant differences were observed between those receiving haloperidol and those receiving placebo in incident delirium (n=15 (22.1%) vs n=19 (28.4%); p = .43), time to delirium (p = .43), delirium duration (median 1 day, interquartile range (IQR) 1-2 days vs median 1 day, IQR 1-2 days; p = .71), delirium severity, ICU length of stay (median 2.2 days, IQR 1-3.3 days vs median 2.3 days, IQR 1-4 days; p = .29), or hospital length of stay (median 10 days, IQR 8-11.5 days vs median 10 days, IQR 8-12 days; p = .41). In the esophagectomy subgroup (n = 84), the haloperidol group was less likely to experience incident delirium (n=10 (23.8%) vs n=17 (40.5%); p = .16). There were no differences in time to delirium (p = .14), delirium duration (median 1 day, IQR 1-2 days vs median 1 day, IQR 1-2 days; p = .71), delirium severity, or hospital length of stay (median 11 days, IQR 10-12 days vs median days 11, IQR 10-15 days; p = .26). ICU length of stay was significantly shorter in the haloperidol group (median 2.8 days, IQR 1.1-3.8 days vs median 3.1 days, IQR 2.1-5.1 days; p = .03). Safety events were comparable between the groups.

conclusionLow-dose postoperative haloperidol did not reduce delirium in individuals undergoing thoracic surgery but may be efficacious in those undergoing esophagectomy. J Am Geriatr Soc 66:2289-2297, 2018.

Indexed as

Thoracic Surgical ProceduresAdministration, IntravenousAntipsychotic AgentsDeliriumDouble-Blind MethodEsophagectomyFemaleHaloperidolHumansIncidenceIntensive Care UnitsLength of StayMaleMiddle AgedPostoperative ComplicationsPsychiatric Status Rating ScalesAntipsychotic AgentsHaloperidolcognitiondeliriumesophagectomyhaloperidolICU

Identifiers

PMID30460981
PMCPMC10924437
OpenAlexW2901927171

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.