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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Death in delirious palliative-care patients occurs irrespective of age : a prospective, observational cohort study of 229 delirious palliative-care patients
Authors: Seiler, Annina
Blum, David
Hertler, Caroline
Schettle, Markus
Zipser, Carl Moritz
Bode, Leonie
Gehrke, Samuel
Ernst, Jutta
Schubert, Maria
von Känel, Roland
Boettger, Soenke
et. al: Yes
DOI: 10.1017/S1478951520000887
Published in: Palliative & Supportive Care
Issue Date: 2020
Publisher / Ed. Institution: Cambridge University Press
ISSN: 1478-9515
Language: English
Subjects: Delirium; Palliative-care patient; Precipitating factor; Predisposing factor
Subject (DDC): 616.8: Neurology, diseases of nervous system
Abstract: Objectives: Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients. Methods: In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age: <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors. Results: In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No intergroup differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.64; confidence interval (CI) 1.90– 6.99; P < 0.001], hypertonia (OR 3.57; CI 1.84–6.92; P < 0.001), and chronic kidney disease (OR 4.84; CI 1.19–19.72; P = 0.028). In contrast, in patients <65 years, only precipitating factors were relevant for delirium, including cerebral edema (OR 0.02; CI 0.01–0.43; P = 0.012). Significance of results: The results of this study demonstrate that death in delirious palliativecare patients occurs irrespective of age. The multifactorial nature and adverse outcomes of delirium across all age in these patients require clinical recognition. Potentially reversible factors should be detected early to prevent or mitigate delirium and its poor survival outcomes.
Further description: Erworben im Rahmen der Schweizer Nationallizenzen (
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Restricted until: 2027-01-01
Departement: Health Professions
Organisational Unit: Institute of Nursing (IPF)
Appears in collections:Publikationen Gesundheit

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