For Cancer Patients in the ER, Delirium Linked to Poor Outcomes

For Cancer Patients in the ER, Delirium Linked to Poor Outcomes

Advanced cancer patients diagnosed with delirium in the emergency department are more likely to be hospitalized and to die earlier than those without delirium, a new study finds.

Researchers looked at nearly 250 people with advanced cancer who were seen in the emergency department at the University of Texas MD Anderson Cancer Center in Houston. According to the investigators, 44 of the patients (18 percent) had delirium.

Delirium is an altered mental state where a person is confused and has trouble thinking or speaking clearly.

Compared to those without delirium, patients diagnosed with the condition were more likely to be admitted to the hospital (80 percent versus 49 percent), and more likely to be admitted to an intensive care unit.

Patients with delirium were also more likely to die earlier than those without delirium, the findings showed. The average survival was one to four months after being seen at the emergency department, compared with an average of more than 10 months for those without a diagnosis of delirium.

The findings, published online Aug. 1 in The Oncologist, show the importance of accurate diagnosis and management of delirium in advanced cancer patients, according to the study authors.

"To the best of our knowledge, this is the first study to show the poor survival of advanced cancer patients in the emergency department setting," lead author Dr. Ahmed Elsayem, of the MD Anderson emergency department, said in a journal news release.

A number of factors can cause delirium in advanced cancer patients, including the disease itself, medications and infections. In many cases, delirium in advanced cancer patients can be resolved by stopping or changing medications or by treating infections, Elsayem said.

More information

The U.S. National Cancer Institute has more on delirium.


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