Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study

Seiler, Annina; Blum, David; Deuel, Jeremy Werner; Hertler, Caroline; Schettle, Markus; Zipser, Carl Moritz; Ernst, Jutta; Schubert, Maria; von Känel, Roland; Boettger, Soenke

doi:10.1017/S147895152000139X

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-24019

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study
Authors:	Seiler, Annina Blum, David Deuel, Jeremy Werner Hertler, Caroline Schettle, Markus Zipser, Carl Moritz Ernst, Jutta Schubert, Maria von Känel, Roland Boettger, Soenke
et. al:	No
DOI:	10.1017/S147895152000139X 10.21256/zhaw-24019
Published in:	Palliative & Supportive Care
Volume(Issue):	19
Issue:	3
Page(s):	294
Pages to:	303
Issue Date:	2021
Publisher / Ed. Institution:	Cambridge University Press
ISSN:	1478-9515 1478-9523
Language:	English
Subjects:	Cancer patient; Delirium; Morbidity; Mortality; Precipitating factor; Predisposing factor; Aged; Cohort study; Human; Prevalence; Prospective study; Risk factor; Hospital mortality; Neoplasm
Subject (DDC):	610.73: Nursing 616: Internal medicine and diseases
Abstract:	Objective: Delirium is a frequent complication in advanced cancer patients, among whom it is frequently underdiagnosed and inadequately treated. To date, evidence on risk factors and the prognostic impact of delirium on outcomes remains sparse in this patient population. Method: In this prospective observational cohort study at a single tertiary-care center, 1,350 cancer patients were enrolled. Simple and multiple logistic regression models were utilized to identify associations between predisposing and precipitating factors and delirium. Cox proportional-hazards models were used to estimate the effect of delirium on death rate. Results: In our patient cohort, the prevalence of delirium was 34.3%. Delirium was associated inter alia with prolonged hospitalization, a doubling of care requirements, increased healthcare costs, increased need for institutionalization (OR 3.22), and increased mortality (OR 8.78). Predisposing factors for delirium were impaired activity (OR 10.82), frailty (OR 4.75); hearing (OR 2.23) and visual impairment (OR 1.89), chronic pneumonitis (OR 2.62), hypertension (OR 1.46), and renal insufficiency (OR 1.82). Precipitating factors were acute renal failure (OR 7.50), pressure sores (OR 3.78), pain (OR 2.86), and cystitis (OR 1.32). On multivariate Cox regression, delirium increased the mortality risk sixfold (HR 5.66). Age ≥ 65 years and comorbidities further doubled the mortality risk of delirious patients (HR 1.77; HR 2.05). Significance of results: Delirium is common in cancer patients and associated with increased morbidity and mortality. Systematically categorizing predisposing and precipitating factors might yield new strategies for preventing and managing delirium in cancer patients.
Further description:	Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch)
URI:	https://digitalcollection.zhaw.ch/handle/11475/24019
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Nursing (IPF)
Appears in collections:	Publikationen Gesundheit

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Seiler, A., Blum, D., Deuel, J. W., Hertler, C., Schettle, M., Zipser, C. M., Ernst, J., Schubert, M., von Känel, R., & Boettger, S. (2021). Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study. Palliative & Supportive Care, 19(3), 294–303. https://doi.org/10.1017/S147895152000139X

Seiler, A. et al. (2021) ‘Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study’, Palliative & Supportive Care, 19(3), pp. 294–303. Available at: https://doi.org/10.1017/S147895152000139X.

A. Seiler et al., “Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study,” Palliative & Supportive Care, vol. 19, no. 3, pp. 294–303, 2021, doi: 10.1017/S147895152000139X.

SEILER, Annina, David BLUM, Jeremy Werner DEUEL, Caroline HERTLER, Markus SCHETTLE, Carl Moritz ZIPSER, Jutta ERNST, Maria SCHUBERT, Roland VON KÄNEL und Soenke BOETTGER, 2021. Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients : results from a prospective cohort study. Palliative & Supportive Care. 2021. Bd. 19, Nr. 3, S. 294–303. DOI 10.1017/S147895152000139X

Seiler, Annina, David Blum, Jeremy Werner Deuel, Caroline Hertler, Markus Schettle, Carl Moritz Zipser, Jutta Ernst, Maria Schubert, Roland von Känel, and Soenke Boettger. 2021. “Delirium Is Associated with an Increased Morbidity and In-Hospital Mortality in Cancer Patients : Results from a Prospective Cohort Study.” Palliative & Supportive Care 19 (3): 294–303. https://doi.org/10.1017/S147895152000139X.

Seiler, Annina, et al. “Delirium Is Associated with an Increased Morbidity and In-Hospital Mortality in Cancer Patients : Results from a Prospective Cohort Study.” Palliative & Supportive Care, vol. 19, no. 3, 2021, pp. 294–303, https://doi.org/10.1017/S147895152000139X.