Prevalencia de delirium mediante la escala Memorial Delirium Assessment Scale (MDAS) en pacientes oncológicos avanzados ingresados en una Unidad de Cuidados Paliativos. Factores de riesgo, reversibilidad y tratamiento recibido

García, Verónica Díaz; Pérez, Miriam Lopez; Reyna, Yolanda Zuriarrain

doi:10.1016/j.medipa.2017.05.002

Cited by 3 publications

(14 citation statements)

References 42 publications

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“…Twelve studies examined the association between primary brain cancer and/or brain metastases and delirium. 42,45,47–50,52,53,55,58,61,62 Positive associations were found in meta-analyses of univariate analyses between delirium and primary brain cancer (OR 2.01, 95% CI 0.98, 4.14) 52,53,62 and brain metastases (OR 3.16, 95% CI 1.85, 5.40) 42,47,48,50 (Supplemental File 6). Seiler et al 62 found a positive association with primary brain cancer in multivariate analysis (OR 3.63, 95% CI 1.03, 12.77).…”

Section: Resultsmentioning

confidence: 98%

“…Several studies excluded patients at high risk of delirium such as those with dementia/cognitive impairment (five studies 46,52,56,59,61 ) and severely ill/dying patients (seven studies 32,33,42,46,48,52,56 ).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with lung cancer may be slightly more likely to have delirium than those without (pooled OR 1.29, 95% CI 0.99, 1.68) (Supplemental Files 6 and 7). 32,33,48–50,52,53,55–58,62…”

Section: Resultsmentioning

confidence: 99%

“…In meta-analysis of univariate data from four studies, presence of metastases (overall) was not associated with delirium period prevalence (OR 0.83, 95% CI 0.66, 1.05) (Supplemental File 6). 52,53,55,61…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included inpatient specialist palliative care units in hospitals ( n = 21) 32,37,39,41,42,44,46,48–53,55–62 or hospice ( n = 5). 33,39,47,51,54 Three studies each included palliative care consultation teams 40,45,49 and palliative care community services 33,41,43…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

et al. 2021

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Background: Delirium is common and distressing for patients receiving palliative care. Interventions targetting modifiable risk factors in other settings have been shown to prevent delirium. Research on delirium risk factors in palliative care can inform context-specific risk-reduction interventions. Aim: To investigate risk factors for the development of delirium in adult patients receiving specialist palliative care. Design: Systematic review and meta-analysis (PROSPERO CRD42019157168). Data sources: CINAHL, Cochrane Database of Systematic Reviews, Embase, MEDLINE and PsycINFO (1980-2021) were searched for studies reporting the association of risk factors with delirium incidence/prevalence for patients receiving specialist palliative care. Study risk of bias and certainty of evidence for each risk factor were assessed. Results: Of 28 included studies, 16 conducted only univariate analysis, 12 conducted multivariate analysis. The evidence for delirium risk factors was limited with low to very low certainty. Potentially modifiable risk factors: Opioids and lower performance status were positively associated with delirium, with some evidence also for dehydration, hypoxaemia, sleep disturbance, liver dysfunction and infection. Mixed, or very limited, evidence was found for some factors targetted in multicomponent prevention interventions: sensory impairments, mobility, catheter use, polypharmacy (single study), pain, constipation, nutrition (mixed evidence). Non-modifiable risk factors: Older age, male sex, primary brain cancer or brain metastases and lung cancer were positively associated with delirium. Conclusions: Findings may usefully inform interventions to reduce delirium risk but more high quality prospective cohort studies are required to enable greater certainty about associations of different risk factors with delirium during specialist palliative care.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

“…Patients with lung cancer may be slightly more likely to have delirium than those without (pooled OR 1.29, 95% CI 0.99, 1.68) (Supplemental Files 6 and 7). 32,33,48–50,52,53,55–58,62…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

et al. 2021

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Clinical applicability of the terminological subset of palliative care for dignified dying

Trybus

Victor

Silva

et al. 2021

Rev. esc. enferm. USP

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Objective: To evaluate the clinical applicability of the terminological subset of the international classification for the nursing practice of palliative care for a dignified dying, in oncology. Method: Prospective study evaluating the clinical applicability of 33 nursing diagnoses/outcomes and 220 nursing interventions. It used case studies of 20 cancer patients undergoing palliation. The nursing process steps were operated by two nurses. Descriptive statistics was used to present, according to the theoretical model, the nursing diagnoses/outcomes and interventions identified in the patients. All statements identified in patients at some point during care were considered applicable in clinical practice. Results: Twenty-nine nursing diagnoses/outcomes and 197 nursing interventions from the subset were identified. Conclusion: In the context of palliative care in patients with cancer, the clinical applicability of 87.8% of the diagnoses/outcomes and 89.5% of the interventions that make up the palliative care terminological subset for dignified dying is affirmed.

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The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study

Llisterri-Sánchez,

Benlloch,

Pérez-Ros

2023

Current Oncology

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Background: Older people with cancer carry a high risk of delirium, an underdiagnosed syndrome due to its diagnostic complexity and often subtle presentation. Tools based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) are available to different health professionals. Our aim is to assess the prevalence of delirium in older people with cancer in an inpatient unit and the accuracy of the Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Methods: This exploratory, cross-sectional study included people aged 65 years or older with a diagnosis of cancer and admitted to the medical oncology unit from June 2021 to December 2022. The diagnostic accuracy of CAM and MDAS was analyzed against the gold standard medical diagnosis based on DSM-5 criteria by two medical oncologists. The cutoff point for the MDAS was determined using a receiver-operating characteristics (ROC) curve. Results. Among the 75 included patients (mean age 71.6 years, standard deviation 4.1; 52% males), the prevalence of delirium was 62.7%. The most prevalent types of cancer in patients with delirium were hematological and lung cancer. The scale with the highest diagnostic accuracy was the CAM, with a sensitivity of 100% and specificity of 86%, followed by the MDAS, with a sensitivity of 88% and specificity of 30%. The presence of cognitive impairment hindered the detection of delirium. Conclusions. The CAM scale was more accurate than the MDAS pre-existing cognitive impairment in our sample. Further studies are needed to analyze the diagnostic accuracy of delirium tools in older populations with cancer and in the presence of cognitive impairment.

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Prevalencia de delirium mediante la escala Memorial Delirium Assessment Scale (MDAS) en pacientes oncológicos avanzados ingresados en una Unidad de Cuidados Paliativos. Factores de riesgo, reversibilidad y tratamiento recibido

Cited by 3 publications

References 42 publications

Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis

Clinical applicability of the terminological subset of palliative care for dignified dying

The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study

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