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Predictors of Delirium in Corticosteroid-Treated Patients with Advanced Cancer: An Exploratory, Multicenter, Prospective, Observational Study.
- Source :
-
Journal of Palliative Medicine . Apr2017, Vol. 20 Issue 4, p352-359. 8p. 4 Charts. - Publication Year :
- 2017
-
Abstract
- Background: Corticosteroids are often used to treat fatigue and anorexia, but occasionally produce delirium. Information on the predictors of delirium in corticosteroid-treated cancer patients remains limited. Objective: To identify potential factors predicting the development of delirium in corticosteroid-treated cancer patients. Design: An exploratory, multicenter, prospective, observational study. Setting/Subjects: Inclusion criteria for this study were patients who had metastatic or locally advanced cancer and a fatigue or anorexia intensity score of 4 or more on a 0-10 Numerical Rating Scale. Measurement: Univariate and multivariable analyses were performed to identify the predictors of delirium diagnosed by the Confusion Assessment Method (CAM) within three days of initiation of corticosteroids. Results: Among 207 patients administered corticosteroids, 35 (17%; 95% confidence interval [CI] 12%-23%) developed at least one episode of delirium diagnosed by the CAM. Factors predictive of the development of delirium were as follows: Palliative Performance Scale ≤20, Eastern Cooperative Oncology Group Performance Status (ECOG PS) = 4, the Support Team Assessment Schedule (STAS) score of drowsiness >1, concurrent opioid use, parenteral hydration volume ≤500 mL, and the absence of lung metastasis. A multivariable analysis identified the independent factors predicting responses as ECOG PS = 4 (odds ratio [OR] 4.0; 95% CI 1.7-9.3), STAS score of drowsiness >1 (OR 3.4; 95% CI 1.4-8.2), and concurrent opioid use (OR 3.7; 95% CI 1.0-13). Conclusion: Delirium in corticosteroid-treated advanced cancer patients may be predicted by PS, drowsiness, and concurrent opioid use. Larger prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANOREXIA nervosa treatment
*COGNITION disorders diagnosis
*DIAGNOSIS of delirium
*FATIGUE (Physiology)
*CORTICOSTEROIDS
*BRAIN tumors
*CANCER patients
*CONFIDENCE intervals
*LIVER tumors
*LONGITUDINAL method
*LUNG tumors
*MEDICAL cooperation
*METASTASIS
*MULTIVARIATE analysis
*ONCOLOGY
*RESEARCH
*RESEARCH funding
*DATA analysis software
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 10966218
- Volume :
- 20
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 122314451
- Full Text :
- https://doi.org/10.1089/jpm.2016.0323