Korean J Psychosom Med.
2018 Dec;26(2):94-101. 10.22722/KJPM.2018.26.2.94.
The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit
- Affiliations
-
- 1Department of Psychiatry, Inha University Hospital, Incheon, Korea. ckgodman@hanmail.net
- 2Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
- KMID: 2437560
- DOI: http://doi.org/10.22722/KJPM.2018.26.2.94
Abstract
OBJECTIVES
The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life.
METHODS
From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily.
RESULTS
The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium.
CONCLUSIONS
Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.
Keyword
MeSH Terms
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Management of Physical Symptoms in Patients with Advanced Cancer during the Last Weeks and Days of Life
- Hospice-Palliative Care Nurses' Knowledge of Delirium, Self-Efficacy and Nursing Performance on Delirium
- The Impact of Nursing Hospital Workers' Hospice·Palliative Care Knowledge and Awareness, End-of-Life Care Attitude and Death Awareness on Their End-of-Life Care Performance
- Factors Influencing Intensive Care Unit Nurses’ Competency in Delirium Care in A Tertiary General Hospital
- Delirium in the intensive care unit
