Haloperidol use is associated with lower hospital mortality in mechanically ventilated patients*

Objective To determine whether haloperidol use is associated with lower mortality in mechanically ventilated patients. Design Retrospective cohort analysis. Setting A large tertiary care academic medical center. Patients A total of 989 patients mechanically ventilated for >48 hrs. Measurements and main results We compared differences in hospital mortality between patients who received haloperidol within 2 days of initiation of mechanical ventilation and those who never received haloperidol. Despite similar baseline characteristics, patients treated with haloperidol had significantly lower hospital mortality compared with those who never received haloperidol (20.5% vs. 36.1%; p = .004). The lower associated mortality persisted after adjusting for age, comorbidity, severity of illness, degree of organ dysfunction, admitting diagnosis, and other potential confounders. Conclusions Haloperidol was associated with significantly lower hospital mortality. These findings could have enormous implications for critically ill patients. Because of their observational nature and the potential risks associated with haloperidol use, they require confirmation in a randomized, controlled trial before being applied to routine patient care.