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Delirium common among hospitalized patients with advanced cancer
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Delirium is common in hospitalized patients with advanced cancer and many factors contribute to its cause, according to findings of a retrospective study.
Michelle Weckmann, MD, MS, an assistant professor in the departments of family medicine and psychiatry at Carver College of Medicine at the University of Iowa, reviewed the charts of 141 random patients with cancer who were admitted to a large academic medical center in 2009.
Weckmann looked for evidence of delirium — a severe neuropsychiatric syndrome characterized by confusion, inability to focus and other impairments to awareness — as well as potential causes.
Study results showed 20 of the 141 patients (14%) exhibited delirium at the time of hospitalization.
Delirium occurrence was 20% (19 of 96) after excluding patients who demonstrated delirium upon admission and patients with non-advanced cancer, and it was 39% (17 of 44) after further excluding patients who were admitted for surgical resection or chemotherapy, study results showed.
The average length of delirium was 4.4 days (range, 1-31 days), and the mean age of patients with delirium was 51 years (range, 43-55 years).
Delirium occurred most frequently in patients with hematological malignancies, lung cancer, and head and neck cancers.
Multiple factors contributed to 69% of delirium cases, Weckmann said. She determined single definitive cause for delirium in eight patients. Four related to intracranial involvement, and two each related to drugs and cardiopulmonary factors.
“Delirium is a distressing condition commonly occurring in patients with advanced cancer,” Weckmann concluded. “This data will be used to design a targeted intervention to prevent delirium in high-risk cancer patients.”
For more information:
- Weckmann M. Abstract #782. Presented at: The Annual Assembly of the American Academy of Hospice and Palliative Medicine & Hospice and Palliative Nurses Association; March 7-10, 2012; Denver.