Open AccessComparison of the prevalence and associated factors of hyperactive delirium in advanced cancer patients between inpatient palliative care and palliative home care
Author(s) -
Hamano Jun,
Mori Masanori,
Ozawa Taketoshi,
Sasaki Jun,
Kawahara Masanori,
Nakamura Asumi,
Hashimoto Kotaro,
Hisajima Kazuhiro,
Koga Tomoyuki,
Goto Keiji,
Fukumoto Kazuhiko,
Morimoto Yuri,
Goshima Masahiro,
Sekimoto Go,
Baba Mika,
Oya Kiyofumi,
Matsunuma Ryo,
Azuma Yukari,
Imai Kengo,
Morita Tatsuya,
Shinjo Takuya
Publication year - 2021
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3661
Subject(s) - medicine , delirium , palliative care , multivariate analysis , logistic regression , prospective cohort study , cancer , emergency medicine , intensive care medicine , nursing
Background Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancer patients between inpatient palliative care and palliative home care on admission and at 3 days before death. Methods This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancer patients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017. Results In total, 2998 patients were enrolled and 2829 were analyzed in this study: 1883 patients in PCUs and 947 patients in palliative home care. The prevalence of agitated delirium between PCUs and palliative home care was 5.2% (95% CI: 4.2% ‐ 6.3%) vs. 1.4% (0.7% ‐ 2.3%) on admission ( p < 0.001) and 7.6% (6.4% ‐ 8.9%) vs. 5.4% (4.0% ‐ 7.0%) 3 days before death ( p < 0.001). However, multivariate logistic regression analysis revealed that the place of care was not significantly associated with the prevalence of agitated delirium at 3 days before death after adjusting for prognostic factors, physical risk factors, and symptoms. Conclusions There was no significant difference in the prevalence of agitated delirium at 3 days before death between inpatient palliative care and palliative home care after adjusting for the patient background, prognostic factors, symptoms, and treatment.