Publication: The prevalence, associated factors, clinical impact, and state of diagnosis of delirium in palliative care patients
Issued Date
2021-12-01
Resource Type
ISSN
14337339
09414355
09414355
Other identifier(s)
2-s2.0-85109316254
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Supportive Care in Cancer. Vol.29, No.12 (2021), 7949-7956
Suggested Citation
Watanachai Klankluang, Sasima Tongsai, Chairat Sriphirom, Arunotai Siriussawakul, Pratamaporn Chanthong, Supakarn Tayjasanant The prevalence, associated factors, clinical impact, and state of diagnosis of delirium in palliative care patients. Supportive Care in Cancer. Vol.29, No.12 (2021), 7949-7956. doi:10.1007/s00520-021-06367-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77561
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
The prevalence, associated factors, clinical impact, and state of diagnosis of delirium in palliative care patients
Other Contributor(s)
Abstract
Purpose: The aim of this study is to establish the prevalence, associated factors, and clinical impact of delirium in newly referred palliative care patients and the percentage of delirium diagnoses missed by primary medical teams. Methods: Newly referred palliative care patients were evaluated and were reviewed for possible associated factors of delirium. Univariable and multivariable analysis were used to identify associated factors. Median overall survival and survival curves were analyzed. The percentage of missed diagnosis in IPD patients was identified. Results: We included 350 palliative care patients. Nearly all patients had cancer diagnosis (96.6%). The overall prevalence of delirium was 44.0%. The independent associated factors of delirium were age ≥ 63 years (adjusted odds ratio [aOR], 7.0; 95% CI, 2.2–22.9), palliative performance scale ≤ 20% (aOR, 54.5; 95% CI, 13.1–228.0), brain metastasis (aOR, 15.6; 95% CI, 3.7–66.7), urinary tract infection (aOR, 18.8; 95% CI, 4.7–75.5), sepsis (aOR, 59.0; 95% CI, 4.4–797.8), hyponatremia (aOR, 8.8; 95% CI, 2.6–29.8), and hypercalcemia (not applicable). Interestingly, opioids and benzodiazepines were not associated with delirium. Delirious patients had significantly shorter survival (median survival 11 days). Delirium diagnoses were missed for 76.1%. Conclusion: Nearly half of the palliative care patients had delirium, which was associated with noticeably short survivals. We identified the independent factors associated with the delirium. Despite having a remarkably high prevalence rate and being a well-known poor prognostic factor, there was still a very high rate of missed delirium diagnoses. Effective, routine, delirium screening of palliative care patients needs to be emphasized.