Sebastiano Mercadante1, Claudio Adile2, Patrizia Ferrera1, Andrea Cortegiani3, Alessandra Casuccio2. 1. a Palliative Care program SAMO , Palermo , Italy. 2. b Department of Sciences for Health Promotion and Mother Child Care , University of Palermo , Italy. 3. c Department of Biopathology , Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico "P, Giaccone", University of Palermo , Italy.
Abstract
BACKGROUND: Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by the Memorial Delirium Assessment Scale (MDAS) and possible associated factors on admission to an acute palliative/supportive care unit (APSCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancer patients who were admitted to an APSCU was prospectively assessed for a period of 10 months. Patient demographics, including age, gender, primary diagnosis, Karnofsky status, stage of disease, and educational level were collected. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS were measured at hospital admission and discharge. RESULTS: A total of 314 patients were surveyed. Of 292 patients with MDAS available at T0, 74 (25.3%) and 24 (8.2%) had a MDAS of 7-12 and ≥13, respectively. At discharge, there was a significant decrease in the number of patients with a MDAS ≥7/30. Higher values of MDAS were associated with age (p = .028), a lower Karnofsky status (p < .0005), gender (male, p = .04), low level of education (p = .002), less awareness of disease (p < .0005), more indications for end-of-life care admission (p < .0005) or other symptoms (p = .026), hospital stay (p = .038) and death (p < .0005). Significant decreases in ESAS were observed in all patients independently of MDAS values (p < .0005). CONCLUSION: Delirium is highly prevalent in patients admitted to APSCU, characterized by a low mortality due to early referral. Comprehensive assessment and treatment may allow a decrease in the level of cognitive disorders and symptom burden.
BACKGROUND:Delirium is often unrecognized in cancerpatients. The aim of this study was to investigate the prevalence of delirium assessed by the Memorial Delirium Assessment Scale (MDAS) and possible associated factors on admission to an acute palliative/supportive care unit (APSCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancerpatients who were admitted to an APSCU was prospectively assessed for a period of 10 months. Patient demographics, including age, gender, primary diagnosis, Karnofsky status, stage of disease, and educational level were collected. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS were measured at hospital admission and discharge. RESULTS: A total of 314 patients were surveyed. Of 292 patients with MDAS available at T0, 74 (25.3%) and 24 (8.2%) had a MDAS of 7-12 and ≥13, respectively. At discharge, there was a significant decrease in the number of patients with a MDAS ≥7/30. Higher values of MDAS were associated with age (p = .028), a lower Karnofsky status (p < .0005), gender (male, p = .04), low level of education (p = .002), less awareness of disease (p < .0005), more indications for end-of-life care admission (p < .0005) or other symptoms (p = .026), hospital stay (p = .038) and death (p < .0005). Significant decreases in ESAS were observed in all patients independently of MDAS values (p < .0005). CONCLUSION:Delirium is highly prevalent in patients admitted to APSCU, characterized by a low mortality due to early referral. Comprehensive assessment and treatment may allow a decrease in the level of cognitive disorders and symptom burden.
Entities:
Keywords:
Advanced cancer; delirium; edmonton symptom assessment scale; memorial delirium assessment scale; palliative care
Authors: Sebastiano Mercadante; Francesco Masedu; Isabella Balzani; Daniela De Giovanni; Luigi Montanari; Cristina Pittureri; Raffaella Bertè; Domenico Russo; Laura Ursini; Franco Marinangeli; Federica Aielli Journal: Support Care Cancer Date: 2017-10-05 Impact factor: 3.603
Authors: Christine L Watt; Franco Momoli; Mohammed T Ansari; Lindsey Sikora; Shirley H Bush; Annmarie Hosie; Monisha Kabir; Erin Rosenberg; Salmaan Kanji; Peter G Lawlor Journal: Palliat Med Date: 2019-06-11 Impact factor: 4.762