title: Predictive factors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital using ordered logistic regression analysis.
abstract: BACKGROUND
  Despite the fact that many cancer patients worldwide die in general hospitals, there are few reports of the analysis of delirium in terminally ill cancer patients in this setting.
  
  
  OBJECTIVE
  This study aimed to identify predictive factors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital.
  
  
  METHODS
  Participants were 182 consecutively admitted terminally ill cancer patients who died in a Japanese general hospital between April 2009 and March 2011. Variables present one week before death were extracted from the clinical records for regression analysis of factors potentially related to agitation severity of delirium. The prevalence and agitation severity of delirium were evaluated retrospectively. Multivariate ordered logistic regression analysis was performed to identify predictive factors.
  
  
  RESULTS
  Male sex [odds ratio (OR)=2.125, 95% confidence interval (CI)=1.111-4.067; P=0.0227]; total bilirubin (T-bil) [OR=1.557, CI=1.082-2.239; P=0.017]; antibiotics [OR=0.450, CI=0.219-0.925; P=0.0298]; nonsteroidal antiinflammatory drugs (NSAIDs) [OR=2.608, CI=1.374-4.950; P=0.0034]; and hematological malignancy [OR=3.903, CI=1.363-11.179; P=0.0112] were found to be statistically significant predictors for agitation severity of hyperactive delirium.
  
  
  CONCLUSIONS
  Our study indicates that male sex, T-bil, antibiotic therapy, NSAID therapy, and hematological malignancy are significant predictors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital setting.
authors.affiliation: 1 Hospital Pharmacy, Kyoto Prefectural University of Medicine , Kyoto, Japan .
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kanbayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hatano
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Hata
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukui
authors.forename: Toyoshi
authors.initials: T
authors.lastname: Hosokawa
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001663:Bilirubin / Q000032:analysis; D003693:Delirium / Q000453:epidemiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications; D006769:Hospitals, General; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011595:Psychomotor Agitation / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D019452:Terminally Ill
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001663:Bilirubin