Occurrence, Causes, and Outcome of Delirium in Patients With Advanced Cancer

Lawlor, Peter G.; Gagnon, Bruno; Mancini, Isabelle; Pereira, José; Hanson, John; Suarez‐Almazor, María E.; Bruera, Éduardo

doi:10.1001/archinte.160.6.786

Cited by 671 publications

(223 citation statements)

References 45 publications

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“…This study like other studies comparing delirious patients to non-delirious controls found that delirious patients are usually older, sometimes this finding reaches statistical significance as found by van Munster et al [11] and other times not [18]. The cases in this study were significantly older (72.4 ± 9.4) than the controls (66.9 ± 5.3) years.…”

Section: Discussionsupporting

confidence: 84%

S100B and delirium in the geriatric acute care setting

Aly¹,

Abdul–Rahman²,

Said³

et al. 2014

AAR

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Delirium and its relation to biochemical markers have been considered a study question in several research works. The relation between S100B levels and delirium is still a matter of discussion. Objective: To compare the serum level of S100B in patients with and without delirium and to detect the relation between S100B and delirium subtypes. Method: A case control study was conducted on 114 elderly (60 years and older) selected from the geriatric acute care unit at Ain Shams University Hospitals. They were classified into two groups; 58 elderly cases who had delirium diagnosed by Confusion Assessment Method and 56 controls. Then delirium was reclassified according to the subtypes of delirium into Hyperactive: 46 patients, hypoactive: 2 patients, and Mixed: 10 patients. Serum S100B levels were determined by ELISA. Results: Cases were significantly older than controls (72.4 ± 9.4 versus 66.9 ± 5.3 years respectively) (P < 0.001). S100B levels were higher in cases (32.4 ± 9.8 pg/ml) than controls (30 ± 9.3 pg/ml) but the difference was not statistically significant (P = 0.19). There was no significant difference in S100B levels between the different subtypes of delirium. Conclusion: Delirious patients had higher S100B levels than controls but the difference was not statistically significant.

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Section: Discussionsupporting

confidence: 84%

S100B and delirium in the geriatric acute care setting

Aly¹,

Abdul–Rahman²,

Said³

et al. 2014

AAR

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“…10 This may be accounted for by the additional delirium risk factors noted in this population. In addition, the peak occurrence of delirium occurred in the second and third weeks posttransplantation.…”

Section: Discussionmentioning

confidence: 92%

“…b Less advanced (LA) disease was defined as acute lymphoblastic leukemia or acute myeloid leukemia in first remission; chronic myeloid leukemia in a chronic phase; or non-Hodgkin lymphoma in first remission, untreated first recurrence, or second remission. More advanced (MA) disease included all other stages of these diseases, all other types of hematologic malignancies, breast carcinoma Ն Stage II, and ovarian carcinoma (see Bensinger et al, 2001 49 10 total body irradiation, 27 and alcohol abuse 23,55,56 all have been implicated in contributing to the occurrence, severity, or duration of delirium or cognitive impairment. Renal and hepatic impairment may be surrogate measures for severe underlying disease and also may impair the metabolism of medications, thus precipitating delirium.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] It is especially common among patients with malignant disease, occurring in 25-40% of patients with malignancies 4 -6 and in 45-85% of those with advanced disease. [7][8][9][10] Delirium is associated with significantly increased morbidity, functional decline, and utilization of health care services. 1,[11][12][13][14] In patients with malignancies, delirium appears to confer an increase in mortality, with excess mortality ratios of 6.2 during hospitalization and 14.1 during 1-5 years of follow-up.…”

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confidence: 99%

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Delirium in patients undergoing hematopoietic stem cell transplantation

Fann

Roth-Roemer²,

Burington

et al. 2002

Cancer

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BACKGROUNDDelirium is common in patients with malignant disease and is associated with significant morbidity. Studies have not examined the epidemiology of delirium in patients undergoing hematopoietic stem cell transplantation (HSCT). The objectives of this study were to determine the prevalence, incidence, severity, and duration of delirium in the acute phase of HSCT and to determine the pretransplantation risk factors for the occurrence and severity of delirium during this period.METHODSNinety adult patients with malignancies who were admitted to the Fred Hutchinson Cancer Research Center for their first HSCT were assessed prospectively from 1 week pretransplantation to 30 days posttransplantation. Delirium occurrence using the Delirium Rating Scale (DRS) and severity using the Memorial Delirium Assessment Scale (MDAS) were assessed three times per week. Pretransplantation risk factors were assessed by patient self‐report, charts, and computerized records.RESULTSThe cumulative posttransplantation incidence of delirium events (DRS score > 12) was 66 (73%), and the incidence of delirium episodes (DRS score > 12 for 2 of 3 consecutive assessments) was 45 (50%). The mean ± standard deviation duration of delirium episodes was 4.8 ± 2.8 assessments (approximately 10 days). Pretransplantation risk factors for having a delirium episode were lower cognitive functioning (Trailmaking B test [a standardized test of visual conceptual and visuomotor tracking and cognitive flexibility]; P = 0.0008), higher blood urea nitrogen (P = 0.002), higher alkaline phosphatase (P = 0.008), lower physical functioning (SF‐12 [self report questionnaire that is a general measure of functioning]; P = 0.03), and higher magnesium (P = 0.03). Pretransplantation risk factors for higher delirium severity scores were higher creatinine (P < 0.0001), the presence of total body irradiation (P = 0.0001), higher magnesium (P = 0.0003), lower Mini‐Mental State Examination score (P = 0.002), malignancy diagnosis category (P = 0.002), female gender (P = 0.008), higher alkaline phosphatase (P = 0.02), older age (P = 0.03), and prior alcohol or drug abuse (P = 0.046).CONCLUSIONSHalf of patients who undergo HSCT experience a delirium episode during the 4 weeks posttransplantation. Pretransplantation risk factors can assist in identifying patients who are more likely to develop delirium posttransplantation. Cancer 2002;95:1971–81. © 2002 American Cancer Society.DOI 10.1002/cncr.10889

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“…(Yu, Park, Hyun, & Lee, 2008). (Chung et al, 2011;Yang, 2010) 을 포함하였고, 생활특성으로는 음주, 흡연, 영양상태, 수면상 태 (Cho, Yoo, Choi, & Kim, 2009;Hwang & Lee, 2010;Kim et al, 2008;Lawlor et al, 2000;Yang, 2010;Yu et al, 2008) 3) 질병 및 수술 관련 특성 질병 관련 특성으로 과거 수술력, 동반질환 여부 (Cho et al, 2009;Chung et al, 2011;Contin et al, 2005;Hwang & Lee, 2010;Kim et al, 2008;Yang, 2010;Yu et al, 2008) (Cho et al, 2009;Chung et al, 2011;Contin et al, 2005;Hwang & Lee, 2010;Jung, Park, & Rim, 2006;Kim et al, 2008;Lawlor et al, 2000;Marcantonio et al, 1998;Yang, 2010;Yu et al, 2008) Table 3과 …”

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Influencing Factors of the Incidence of Delirium in Elderly Patients with Arthroplasty

Lee¹,

Im²,

Jeong³

et al. 2012

Korean J Adult Nurs

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Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, x 2 -test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender (x 2 =6.11, p=.025), age (x 2 =32.81, p<.001), hearing difficulty (x 2 =8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

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Occurrence, Causes, and Outcome of Delirium in Patients With Advanced Cancer

Cited by 671 publications

References 45 publications

S100B and delirium in the geriatric acute care setting

S100B and delirium in the geriatric acute care setting

Delirium in patients undergoing hematopoietic stem cell transplantation

Influencing Factors of the Incidence of Delirium in Elderly Patients with Arthroplasty

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