Outcomes of Patients With Delirium Admitted to Acute Palliative Care Unit Assessed

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Patients with advanced cancer and delirium at an acute palliative care unit had a poorer survival rate.
Patients with advanced cancer and delirium at an acute palliative care unit had a poorer survival rate.

Patients with advanced cancer and delirium at an acute palliative care unit (APCU) had a poorer survival rate than those who were not diagnosed with delirium, according to an article published online ahead of print in The Oncologist.1

Investigators sought to examine the frequency, characteristics, and outcomes of delirium in patients with advanced cancer admitted to an APCU.

They analyzed medical records of 609 consecutive patients admitted to the APCU from January 2011 through December 2011.

Data on patients' demographics; Memorial Delirium Assessment Scale (MDAS) score; palliative care specialist (PCS) diagnosis of delirium; delirium etiology, subtype, and reversibility; late development of delirium; and discharge outcome were collected.

Delirium was diagnosed with MDAS score ≥7 and by a PCS using Diagnostic and Statistical Manual, 4th edition, Text Revision criteria. All patients admitted to the APCU received standardized assessments and management of delirium per best practice guidelines in delirium management.

Results showed that 58% out of 556 patients in the APCU had a diagnosis of delirium. Of these, 71% of patients had a delirium diagnosis upon admission and 29% of patients developed delirium after admission to the APCU. Delirium reversed in approximately one-third of patients. Half of patients with delirium died.

RELATED: Rates for Palliative Care Consultation Low Regardless of Race, Ethnicity

Patients with delirium had a lower median overall survival compared with patients who did not. Patients who developed delirium after admission had poorer survival (P≤0.0001) and a lower rate of delirium reversal (P=0.03).

Results from this study can assist clinicians in decision-making regarding other medical interventions, advance care planning, and communication with family members regarding end-of-life issues.

Reference

  1. de la Cruz M, Ransing V, Yennu S, et al. The frequency, characteristics, and outcomes among cancer patients with delirium admitted to an acute palliative care unit. [published online ahead of print September 28, 2015]. Oncologist. doi: 10.1634/theoncologist.2015-0115.

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