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In-hospital haloperidol use and perioperative changes in QTc-duration

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Haloperidol may prolong ECG QTc-duration but is often prescribed perioperatively to hip-fracture patients. We aimed to determine (1) how QTc-duration changes perioperatively, (2) whether low-dose haloperidol-use influences these changes, and (3) which clinical variables are associated with potentially dangerous perioperative QTc-prolongation (PD-QTc; increase >50 ms or to >500 ms).

Design

Prospective cohort study.

Setting

Tertiary university teaching-hospital.

Participants

Patients enrolled in a randomized controlled clinical trial of melatonin versus placebo on occurrence of delirium in hip-fracture patients.

Measurements

Data from ECGs made before and after hip surgery (1–3 days and/or 4–6 days post-surgery) were analyzed. QTc-duration was measured by hand, blinded for haloperidol and pre/post-surgery status. Clinical variables were measured at baseline. Mixed model analysis was used to estimate changes in QTc-duration. Risk-factors for PD-QTc were estimated by logistic regression analysis.

Results

We included 89 patients (mean age 84 years, 24% male); 39 were treated with haloperidol. Patients with normal pre-surgery QTc-duration (male ≤430 ms, female ≤450 ms) had a significant increase (mean 12 ms, SD 28) in QTc-duration. A significant decrease (mean 19 ms, SD 34) occurred in patients with prolonged pre-surgery QTc-duration (male >450ms, female >470 ms). Haloperidol-use did not influence the perioperative course of the QTc-interval (p=0.351). PD-QTc (n=8) was not associated with any of the measured risk-factors.

Conclusion

QTc-duration changed differentially, increasing in patients with normal, but decreasing in patients with abnormal baseline QTc-duration. PD-QTc was not associated with haloperidol-use or other risk-factors. Low-dose oral haloperidol did not affect perioperative QTc-interval.

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Author information

Authors and Affiliations

  1. Department of Cardiology, Heart Center, Amsterdam, The Netherlands

    M. T. Blom & H. L. Tan

  2. Department of Internal Medicine, section of Geriatric Medicine, Academic Medical Center, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands

    S. Jansen, A. de Jonghe, S. E. de Rooij & Nathalie van der Velde

  3. Department of Geriatrics, Tergooi Hospitals, Blaricum, the Netherlands

    A. de Jonghe

  4. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    B. C. van Munster

  5. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands

    A. de Boer

Authors
  1. M. T. Blom
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  2. S. Jansen
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  3. A. de Jonghe
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  4. B. C. van Munster
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  8. Nathalie van der Velde
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Correspondence to Nathalie van der Velde.

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Blom, M.T., Jansen, S., de Jonghe, A. et al. In-hospital haloperidol use and perioperative changes in QTc-duration. J Nutr Health Aging 19, 583–589 (2015). https://doi.org/10.1007/s12603-015-0465-4

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  • DOI: https://doi.org/10.1007/s12603-015-0465-4

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