title: Prevalence of delirium among patients at a cancer ward: Clinical risk factors and prediction by bedside cognitive tests.
abstract: Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine the value of cognitive testing in the assessment of delirium. Methods On five different days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System and the Confusion Assessment Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious participants were CAM positive. Poor performance on the cognitive tests was associated with delirium. Medical records describing CNS metastases, benzodiazepine or morphine treatment were associated with delirium. Conclusions Delirium is prevalent among cancer inpatients. The Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient profile for the detection of delirium.
authors.affiliation: a Psychiatric Center Nordsjaelland , Hilleroed, Denmark ;
authors.forename: Mia Gall
authors.initials: MG
authors.lastname: Grandahl
authors.affiliation: b Department of Oncology and Palliation, North Zealand Hospital , Hilleroed, Denmar ;
authors.forename: Svend Erik
authors.initials: SE
authors.lastname: Nielsen
authors.affiliation: c Private Practice , Denmark ;
authors.forename: Ejnar Alex
authors.initials: EA
authors.lastname: Koerner
authors.affiliation: d Department of Cardiology, Nephrology and Endocrinology, North Zealand Hospital , Hilleroed, Denmark ;
authors.forename: Helga Holm
authors.initials: HH
authors.lastname: Schultz
authors.affiliation: e Psychiatric Hospital Slagelse, Region Zealand, University of Copenhagen , Denmark.
authors.forename: Sidse Marie
authors.initials: SM
authors.lastname: Arnfred
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003430:Cross-Sectional Studies; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology; D009483:Neuropsychological Tests; D016522:Oncology Service, Hospital; D000067716:Point-of-Care Testing; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
keywords: Delirium; cancer; cognitive testing; liaison; predictors; prevalence