Symptom Expression in Patients with Advanced Cancer Admitted to an Acute Supportive/Palliative Care Unit With and Without Delirium.
Aged
Behavior Rating Scale
/ statistics & numerical data
Cancer Pain
/ diagnosis
Cognition
Delirium
/ diagnosis
Depression
/ diagnosis
Female
Hospitalization
/ statistics & numerical data
Humans
Karnofsky Performance Status
/ statistics & numerical data
Male
Middle Aged
Neoplasm Staging
Neoplasms
/ complications
Neuropsychological Tests
/ statistics & numerical data
Pain Measurement
/ statistics & numerical data
Palliative Care
/ statistics & numerical data
Prospective Studies
Severity of Illness Index
Symptom Assessment
/ statistics & numerical data
Treatment Outcome
Advanced cancer
Delirium
Edmonton Symptom Assessment Scale
Memorial Delirium Assessment Scale
Palliative care
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
20
04
2018
accepted:
18
09
2018
pubmed:
26
10
2018
medline:
21
7
2020
entrez:
26
10
2018
Statut:
ppublish
Résumé
The aim of this study was to investigate the relationship between delirium and symptom expression in patients with advanced cancer admitted to an acute supportive/palliative care unit (ASPCU). A consecutive sample of patients with advanced cancer who were admitted to an ASPCU was prospectively assessed for a period of 10 months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after 7 days of palliative care (T7). Two hundred forty-six patients had complete data regarding MDAS measurements, at either T0 and T7. Of these, 75 (30.5%) and 63 patients (25.6%) had delirium at T0 and after a week of palliative care (T7), with a decrease in the frequency of delirium of 4.9% (from 30.5% to 25.6%); that means that 16% of patients with delirium improved their cognitive status after initiation of palliative care. Intensities of pain, depression, poor well-being, and global ESAS were significantly higher in patients with delirium. Patients who did not have delirium at T0 but developed delirium during admission after 1 week of palliative care had a higher level of symptom expression for pain, weakness, nausea, anxiety, dyspnea, appetite, and consequently global ESAS. Patients who did not develop delirium at any time had a relevant decrease in intensity of all ESAS items after 1 week of palliative care. The decrease of symptom intensity was significant for pain, insomnia, appetite, poor well-being, and global ESAS in patients with delirium either at T0 and T7, although these differences were less relevant than those observed in patients without delirium. In patients with delirium at T0 who improved their cognitive function at T7 (no delirium), significant changes were found in most ESAS items. Symptom expression is amplified in patients with delirium, whereas patients without delirium may be more responsive to palliative treatments with a significant decrease in intensity of ESAS items. Symptom expression is amplified in patients with cancer who have delirium, whereas patients without delirium may be more responsive to palliative treatments with a significant decrease in symptom intensity.
Identifiants
pubmed: 30355776
pii: theoncologist.2018-0244
doi: 10.1634/theoncologist.2018-0244
pmc: PMC6656486
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e358-e364Informations de copyright
© AlphaMed Press 2018.
Déclaration de conflit d'intérêts
Disclosures of potential conflicts of interest may be found at the end of this article.
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