Korean J Hosp Palliat Care.  2014 Sep;17(3):170-178. 10.14475/kjhpc.2014.17.3.170.

Risk Factors Related to Development of Delirium in Hospice Patients

• Ko HJ
• Youn CH
• Chung SE
• Kim AS
• Kim HM

• KMID: 2305288
• DOI: http://doi.org/10.14475/kjhpc.2014.17.3.170

Abstract

PURPOSE
Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients. We investigated risk factors related to the development of delirium among hospice care patients.
METHODS
Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests performed at the time of patient's admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox's proportional hazard model was performed using significant factors of logistic regression analysis.
RESULTS
Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE<24), depression (BDI> or =16), and insomnia (ISI> or =15) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009~13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009~13.097) were found significant using Cox's proportional hazard model.
CONCLUSION
The development of delirium was significantly related to depression and cognitive impairment among patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.

Keyword

Cognitive disorders; Delirium; Depression; Hospice care

MeSH Terms

Anxiety
Delirium*
Depression
Diagnostic and Statistical Manual of Mental Disorders
Hospice Care
Hospices*
Humans
Logistic Models
Proportional Hazards Models
Psychometrics
Risk Factors*
Sleep Initiation and Maintenance Disorders
Substance-Related Disorders
Terminally Ill