Titre du document / Document title

Impact of delirium on the short term prognosis of advanced cancer patients

Auteur(s) / Author(s)

Italian Multicenter Study Group on Palliative Care, ITALIE
CARACENI A. ⁽¹⁾ ; NANNI O. ⁽²⁾ ; MALTONI M. ⁽²⁾ ; PIVA L. ⁽³⁾ ; INDELLI M. ⁽⁴⁾ ; ARNOLDI E. ⁽⁵⁾ ; MONTI M. ⁽⁶⁾ ; MONTANARI L. ⁽⁷⁾ ; AMADORI D. ⁽²⁾ ; DE CONNO F. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Unita'di Riabilitazione e Terapie Palliative, Department of Anesthesia and Critical Care, National Cancer Institute of Milan, ITALIE
⁽²⁾ Divisione di Oncologia Medica, Ospedale Pierantoni, Istituto Oncologico Romagnolo, Forli', ITALIE
⁽³⁾ Divisione di Terapia del Dolore e Cure Palliative, Istituti Clinici di Perfezionamento, Milan, ITALIE
⁽⁴⁾ Divisione di Oncologia Medica, Ospedale S. Anna, Ferrara, ITALIE
⁽⁵⁾ Divisione di Oncologia Medica, Ospedale di Trescore, Seriate, ITALIE
⁽⁶⁾ Hospice Pio Albergo Trivulzio, Milan, ITALIE
⁽⁷⁾ Divisione di Oncologia Medica, Ospedale Civile, Lugo, ITALIE

Résumé / Abstract

BACKGROUND. The objective of this study was to evaluate the impact of delirium on the survival of advanced cancer patients also assessed with a validated prognostic score (the palliative prognostic [PaP] score). METHODS. The study population was a prospective multicenter consecutive case series of advanced cancer patients for whom chemotherapy was no longer considered viable and who were referred to palliative care programs. Clinical and biologic prognostic factors included in the PaP score were assessed at study entry. The Confusion Assessment Method criteria were applied to screen patients presenting with delirium. Survival times were measured from time of enrollment and death taken as an outcome. Survival curves were traced with the Kaplan-Meier method and comparison were based on log rank tests. RESULTS. Delirium was found in 109 cases among 393 consecutive patients (27.7%). The diagnosis of delirium was independently associated with male gender, central nervous system metastases, lower performance status, worse clinical prediction of survival, and progestational treatment. The survival curve of patients with delirium was significantly different from the nondelirious patients curve (log rank, 31.6, P < 0.0001). The median survival time was 21 days (95% confidence interval [CI], 16-27) for the delirious patients and 39 days (95% CI 33-49) for the others. Multivariate analysis showed that the diagnosis of delirium and PaP score were independently associated with prognosis. CONCLUSIONS. The diagnosis of delirium significantly worsens life expectancy prognosticated with the PaP score. By using the PaP score together with the assessment of cognitive status, physicians can correctly predict patients 30-day survival in greater than 70% of cases.

Revue / Journal Title

Cancer   ISSN 0008-543X   CODEN CANCAR 

Source / Source

2000, vol. 89, n^o5, pp. 1145-1149 (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1948) (Revue)

Mots-clés anglais / English Keywords

Malignant tumor ; Advanced stage ; Association ; Delirium ; Prognosis ; Survival ; Short term ; Human ; Organic mental disorder ;

Mots-clés français / French Keywords

Tumeur maligne ; Stade avancé ; Association ; Délirium ; Pronostic ; Survie ; Court terme ; Homme ; Trouble mental organique ;

Mots-clés espagnols / Spanish Keywords

Tumor maligno ; Estadio avanzado ; Asociación ; Delirio ; Pronóstico ; Sobrevivencia ; Corto plazo ; Hombre ; Trastorno mental orgánico ;

Localisation / Location

INIST-CNRS, Cote INIST : 2701, 35400009124463.0240