BACKGROUND: Delirium is a potentially distressing complication in patients receiving palliative care. In some studies it seems to be common however there is a wide-range of incidence and prevalence in the literature, in such populations. AIM: To evaluate the occurrence of delirium in patients followed by a palliative care service with inpatient support team and outpatient clinic; to evaluate if there is association between diagnosis of delirium and place where patients are followed in a palliative care service (inpatients and outpatients) and to evaluate if there is association between diagnosis of delirium and mortality. METHODS: Prospective study conducted from 1st January to 31th March 2011, in a central university teaching hospital. All the inpatients and outpatients admitted to the service during this period were invited to participate and were evaluated with Confusion Assessment Method (CAM) and Mini-Mental State Examination (MMSE) (inpatients every three days; outpatients in all ambulatory consultations, with intervals longer than three days). RESULTS: Of the 119 patients evaluated (114 with cancer) delirium was diagnosed in 49 (41,2%): 11 out of 45 patients evaluated only as outpatients (24,4%); 27 out of 49 patients evaluated only as inpatients (55,1%); 11 out of 25 patients evaluated both as inpatient and outpatient (44,0%) (p<0,05). During the study period 51 patients died and 33 of them (64,7%) were diagnosed delirium whereas only 12 of the 53 patients alive at the end of the study (22,6%) had this diagnosis (p <0.05). The risk of dying was higher in patients with delirium (relative risk 2,40; 95% CI: 1,57-3,67). Patients with delirium had shorter survival than patients without delirium (p<0,001). None of the five non cancer patients enrolled in the study (4,2%) was diagnosed with delirium. CONCLUSIONS: In this study, 41,2% of the palliative care population had delirium, being more frequent in the inpatients setting as well as in the patients who died during the period of the study. Delirium was associated with a higher risk of dying (relative risk=2,40).
Date of Award | Sept 2012 |
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Original language | Portuguese |
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Awarding Institution | - Universidade Católica Portuguesa
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Supervisor | João Amado (Supervisor) & Edna Gonçalves (Co-Supervisor) |
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- Palliative care
- Inpatient support
- Outpatient clinic
- Mortality
- Mestrado em Cuidados Paliativos
Delirium: dimensão do problema num serviço de cuidados paliativos
Moreira, C. F. N. D. R. (Student). Sept 2012
Student thesis: Master's Thesis