Delirium in terminal cancer: a prospective study using daily screening, early diagnosis, and continuous monitoring.
A pilot prospective cohort study was conducted to determine delirium frequency and outcome in cancer patients consecutively hospitalized for terminal care (median stay: 12 days). Screening for delirium symptoms was performed daily, using the Confusion Rating Scale. Patients positive on screening had a diagnostic assessment within 24 hours using the Confusion Assessment Method. Monitoring of symptoms was continued until death. Eighteen (20%) of the 89 study patients were positive on screening at admission. Among the 71 patients free of delirium at admission, the incidence of confirmed delirium was 32. 8% (95% CI, 21.3-44.3%). Patients positive on screening received a higher mean equivalent parenteral daily dose of morphine than other patients (72 mg vs. 41 mg, p = 0.08). Significant symptom improvement occurred in 16 (50%) of the 32 delirious cases. Delirium is a serious and frequent complication in terminal cancer whose outcome may not be as poor as previously considered.
Gagnon
P
P
The Maison Michel Sarrazin, Laval University, Québec City, Province of Québec, Canada.
Allard
P
P
Mâsse
B
B
DeSerres
M
M
D000368:Aged; D002170:Canada; D016638:Critical Illness / Q000523:psychology*; D003693:Delirium / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D011446:Prospective Studies