BACKGROUNDS In
terminally ill cancer patients,
delirium must be considered to be important clinically and for the
quality of life. We reviewed cases of
delirium in hospitalized
cancer patients with the aim to recognize and treat
delirium.
METHODS:
We reviewed retrospectively the
medical records of
patients admitted with terminal
cancer from April 2003 to April 2004 in the department of
family medicine,
National Health Insurance Corporation Ilsan
Hospital. A total of 71
patients were evaluated with age,
sex, oncological
diagnosis,
metastases,
morphine (oral
morphine equivalents/day, OME) use and amount,
sedatives use, duration from
delirium to
death, and
laboratory fi ndings.
Analysis was conducted to fi nd the characteristics of
delirium patients and to quantify the relationship between
delirium and predicting factors.
RESULTS:
Among 71 cases, those
patients who developed
delirium were 41 (57.7%). Among them,
gastric cancer was the most common
diagnosis with 10
patients (24.4%), followed by
colon and
lung cancers (9 22%, 5 12.2%). The
patients receiving
sedatives or
morphines were 24 (58.5%) and 28 (68.3%), respectively. The mean amount of
morphine was 168.6 +/- 125.5 mg OME/day.
Hyperbilirubinemia (4.2 +/- 9.2 mg/dL) and
hyponatremia (132.5 +/- 4.5 mM/L) were found. Not only
bone metastasis and the use of
morphine or
sedatives but
serum Na were significant (P = 0.047; P < 0.001; P = 0.069; P = 0.029). By
logistic regression analyses, the occurrence of
delirium was increased with decreased
serum Na (
odds ratio [95% CI] 0.798 [0.649-0.981]) and increased use of
sedatives (5.955 [1.080-32.835]).
CONCLUSION:
In
terminally ill cancer patients, the
risk factors of
delirium were
bone metastasis, the use of
morphine or
sedatives, and
serum Na level. Among these, the use of
sedatives and
serum Na level were independent
risk factors.