Treatment and Support in Confusional States

Lesko, Lynna M.; Fleishman, Stewart B.

doi:10.1007/978-3-642-84138-5_45

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…In addition to supportive symptomatic measures, the management of delirium includes diagnosis and treatment of the underlying causes [23,35]. As our study demonstrated, confirming what is reported in the literature, antipsychotic drugs are the cornerstone of syruptomatic treatment for delirium, with the drug of choice being haloperidol [15,34,38,40,45].…”

Section: Discussionsupporting

confidence: 91%

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

Olofsson

Weitzner

Valentine

et al. 1996

Support Care Cancer

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This report describes the evaluation and treatment of delirium in the cancer patient in a major comprehensive cancer center. Ninety consecutive cases of delirium seen by the inpatient psychiatry consultation/liaison service were analyzed in a retrospective fashion to evaluate demographic information, alcohol use, central nervous system disease, coexisting medical disease, and past psychiatric history. Delirium cases were divided into hyperalert, hypoalert, and mixed subtypes. For these three subtypes, medication profiles including dose of medication, duration of delirium, outcome, and the venue where the delirium began were also evaluated. The hyperalert subtype of delirium was the commonest type observed (71%) and had the shortest duration (P < 0.0001) and best outcome (P < 0.001). The patients with a hyperalert delirium subtype were treated with the least amount of haloperidol (P < 0.0001). Patients were delirious for longer when the delirium began in the intensive-care units (P < 0.04). In general, patients who received no haloperidol experienced delirium of longer duration (P < 0.02) than those receiving haloperidol. Since the data represent patients who were referred for psychiatric treatment, this may explain the increased number of hyperalert deliriums and, therefore, the generalizability of the results is limited. Delirium in the cancer patient is particularly problematic given the coexisting medical problems these patients experience. Because the outcome of delirium is better when the duration is shorter, it is important for clinicians to be sensitive to early symptoms so that treatment can be implemented faster, leading to less morbidity and mortality.

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Section: Discussionsupporting

confidence: 91%

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

Olofsson

Weitzner

Valentine

et al. 1996

Support Care Cancer

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“…The failure to identify and intervene in reversible delirium could have serious, even lethal, consequences. 8, 13 Delirium may precede death; however, delirium may be reversible even in terminal cases ( Table 3). Appropriate treatment of delirium can greatly affect length of survival and quality of life.…”

Section: Delay In Diagnoses Of Deliriummentioning

confidence: 99%

Delirium in the older person with cancer

Weinrich¹,

Sarna²

1994

Cancer

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Delirium occurs in 25–40% of patients with cancer and in as many as 85% of patients with advanced cancer. Delirium, or acute confusion, can be short term and reversible and differs from dementia, which is chronic and irreversible. Accurate assessment is critical for effective treatment and to reduce the increased mortality associated with delirium. Assessment for differentiating depression as well as dementia is needed, because mistaken diagnoses often prolong and exacerbate the symptoms of delirium. Different treatment strategies are appropriate depending on the cause(s) of confusion. In this article, risk factors and assessment tools are reviewed, and interventions for delirium in older persons with cancer are presented. Future areas for research are identified, because there is a paucity of research on delirium in older patients with cancer.

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Treatment and Support in Confusional States

Cited by 2 publications

References 11 publications

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

Delirium in the older person with cancer

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