Delirium at the end of life.
BACKGROUND
Delirium is common in the last weeks of life, occurring in 26-44% of people with advanced cancer in hospital, and in up to 88% of people with terminal illness in the last days of life.


METHODS
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions at the end of life in people with delirium caused by underlying terminal illness? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2006 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found three systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: artificial hydration, barbiturates, benzodiazepines, haloperidol, opioid switching, phenothiazines, and propofol.
Keeley
Paul W
PW
Glasgow Royal Infirmary, Glasgow, UK.
D003693:Delirium; D014481:United States; D014486:United States Food and Drug Administration