Delirium in oncological palliative care and clinical cardiology units: A comparative analysis.

Autor: Grisales, Elisa Sánchez, Higuita, Ana María, Correa, Marcela Escobar, Gómez, John Jairo Vargas, González, Carolina Palacio, Daveloza, Alicia Krikorian, Vásquez, José Gabriel Franco
Zdroj: Palliative & Supportive Care; Oct2023, Vol. 21 Issue 5, p805-811, 7p
Abstrakt: Objective: The aim of this study was to compare the sociodemographic and clinical characteristics of delirium in patients treated in a clinical cardiology unit (CCU) and an oncological palliative care unit (OPCU) at a high-complexity institution. Context: Delirium is a neuropsychiatric syndrome with multicausal etiology, associated with increased morbidity and mortality. Method: This was a cross-sectional, analytical observational study. CCU and OPCU patients were evaluated for 480 days. The diagnosis was made according to DSM-V. Sociodemographic characteristics, the Karnofsky index, and the Charlson index were evaluated. Possible etiologies were verified. Severity was assessed with the Delirium Severity Scale (DRS-R98). Results: A total of 1,986 patients were evaluated, 205 were eligible, and 110 were included in the study (CCU: 61, OPCU: 49). Delirium prevalence was 11.35% in the CCU and 9.87% in the OPCU. CCU patients were 12 years older (p < 0.03) and a history of dementia (41 vs. 8.2%; p < 0.001). Organ failure was the most frequent etiology of delirium in the CCU (41.0%), and in the OPCU, the etiologies were neoplasms (28.6%), side effect of medication (22.4%), and infections (2.5%). Differences were found in the clinical characteristics of delirium evaluated by DRS-R98, with the condition being more severe and with a higher frequency of psychotic symptoms in OPCU patients. Conclusion: Delirium was a common condition in hospitalized patients in the CCU and the OPCU. The clinical characteristics were similar in both groups; however, significant differences were found in OPCU patients in terms of age, personal history of dementia, and opioid use, as well as the severity of delirium and a greater association with psychotic symptoms. These findings have implications for the early implementation of diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index