Delirium in advanced cancer : screening for the incidence on admission to an inpatient hospice unit

Rainsford, Suzanne, Rosenberg, John P., & Bullen, Tracey (2014) Delirium in advanced cancer : screening for the incidence on admission to an inpatient hospice unit. Journal of Palliative Medicine, 17(9), pp. 1045-1048.

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Abstract

Background

Delirium is a common underdiagnosed condition in advanced cancer leading to increased distress, morbidity, and mortality. Screening improves detection but there is no consensus as to the best screening tool to use with patients with advanced cancer.

Objective

To determine the incidence of delirium in patients with advanced cancer within 72 hours of admission to an acute inpatient hospice using clinical judgement and validated screening tools.

Method

One hundred consecutive patients with advanced cancer were invited to be screened for delirium within 72 hours of admission to an acute inpatient hospice unit. Two validated tools were used, the Delirium Rating Scale-Revised 98 (DRS-R-98) and the Confusion Assessment Method (CAM) shortened diagnostic algorithm. These results were compared with clinical assessment by review of medical charts.

Results

Of 100 consecutive admissions 51 participated and of these 22 (43.1%) screened positive for delirium with CAM and/or DRS-R-98 compared to 15 (29.4%) by clinical assessment. Eleven (21.6%) were identified as hypoactive delirium and 5 (9.8%) as subsyndromal delirium.

Conclusion

This study confirms that delirium is a common condition in patients with advanced cancer.While there remains a lack of consensus regarding the choice of delirium screening tool this study supports theCAMas being appropriate. Further research may determine the optimal screening tool for delirium enabling the development of best practice clinical guidelines for routinemedical practice.

Impact and interest:

9 citations in Scopus
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6 citations in Web of Science®

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ID Code: 78585
Item Type: Journal Article
Refereed: Yes
DOI: 10.1089/jpm.2013.0646
ISSN: 1557-7740
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2014 Mary Ann Liebert, Inc. Publishers
Deposited On: 11 Nov 2014 22:55
Last Modified: 12 Nov 2014 22:18

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