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Published in: Supportive Care in Cancer 1/2013

01-01-2013 | Original Article

Impact of pneumonia on hyperactive delirium in end-stage lung cancer patients

Authors: Hidekazu Suzuki, Tomonori Hirashima, Masashi Kobayashi, Norio Okamoto, Yuka Matsuura, Motohiro Tamiya, Naoko Morishita, Kohei Okafuji, Takayuki Shiroyama, Osamu Morimura, Satomu Morita, Ichiro Kawase

Published in: Supportive Care in Cancer | Issue 1/2013

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Abstract

Purpose

Patients with incurable lung cancer often receive palliative care. Hyperactive delirium is a burden not only for the patient’s family but also for caregivers. There are no reports describing the risk factors for delirium among lung cancer patients. The present study investigated the frequency of incidence and risk factors for hyperactive delirium among end-stage lung cancer patients.

Methods

Patients who died of lung cancer in our institute from January 2010 to December 2010 were retrospectively investigated. Information was obtained from medical records, and patients who developed hyperactive delirium (delirium group, group D) were compared with patients who did not (control group, group C) based on clinical and laboratory data.

Results

A total of 146 patients (median age, 70 years; 80 % male) died of lung cancer. Thirty-one (21.2 %) patients developed hyperactive delirium. Sex (P = 0.0093) and pneumonia (P = 0.023) were statistically significant variables in univariate analysis. Pneumonia occurred in 27.4 % of all patients. The incidence of pneumonia was 45.2 % in group D and 22 % in group C. Only pneumonia (odds ratio, 2.89; 95 % confidence interval, 1.22–6.85; P = 0.016) was identified as a significant factor for predicting hyperactive delirium in multivariate analysis.

Conclusions

Pneumonia was identified as a significant risk factor for the development of hyperactive delirium among end-stage lung cancer patients.
Literature
1.
go back to reference Massie MJ, Holland J, Glass E (1983) Delirium in terminally ill cancer patients. Am J Psychiatry 140:1048–1050PubMed Massie MJ, Holland J, Glass E (1983) Delirium in terminally ill cancer patients. Am J Psychiatry 140:1048–1050PubMed
2.
go back to reference Lawlor PG, Gagnon B, Mancini IL, Pereira JL, Hanson J, Suarez-Almazor ME et al (2000) Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med 160:786–794PubMedCrossRef Lawlor PG, Gagnon B, Mancini IL, Pereira JL, Hanson J, Suarez-Almazor ME et al (2000) Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med 160:786–794PubMedCrossRef
3.
go back to reference Caraceni A, Nanni O, Maltoni M, Piva L, Indelli M, Arnoldi E et al (2000) Impact of delirium on the short term prognosis of advanced cancer patients. Italian Multicenter Study Group on Palliative Care. Cancer 89:1145–1149PubMedCrossRef Caraceni A, Nanni O, Maltoni M, Piva L, Indelli M, Arnoldi E et al (2000) Impact of delirium on the short term prognosis of advanced cancer patients. Italian Multicenter Study Group on Palliative Care. Cancer 89:1145–1149PubMedCrossRef
4.
go back to reference Bruera E, Bush SH, Willey J, Paraskevopoulos T, Li Z, Palmer JL et al (2009) Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers. Cancer 115:2004–2012PubMedCrossRef Bruera E, Bush SH, Willey J, Paraskevopoulos T, Li Z, Palmer JL et al (2009) Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers. Cancer 115:2004–2012PubMedCrossRef
5.
go back to reference Breitbart W, Gibson C, Tremblay A (2002) The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics 43:183–194PubMedCrossRef Breitbart W, Gibson C, Tremblay A (2002) The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics 43:183–194PubMedCrossRef
6.
go back to reference Bush SH, Bruera E (2009) The assessment and management of delirium in cancer patients. Oncologist 14:1039–1049PubMedCrossRef Bush SH, Bruera E (2009) The assessment and management of delirium in cancer patients. Oncologist 14:1039–1049PubMedCrossRef
7.
go back to reference Akechi T, Nakano T, Okamura H, Ueda S, Akizuki N, Nakanishi T et al (2001) Psychiatric disorders in cancer patients: descriptive analysis of 1721 psychiatric referrals at two Japanese cancer center hospitals. Jpn J Clin Oncol 31:188–194PubMedCrossRef Akechi T, Nakano T, Okamura H, Ueda S, Akizuki N, Nakanishi T et al (2001) Psychiatric disorders in cancer patients: descriptive analysis of 1721 psychiatric referrals at two Japanese cancer center hospitals. Jpn J Clin Oncol 31:188–194PubMedCrossRef
8.
go back to reference Morita T, Tei Y, Tsunoda J, Inoue S, Chihara S (2001) Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. J Pain Symptom Manage 22:997–1006PubMedCrossRef Morita T, Tei Y, Tsunoda J, Inoue S, Chihara S (2001) Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. J Pain Symptom Manage 22:997–1006PubMedCrossRef
9.
go back to reference Ljubisavljevic V, Kelly B (2003) Risk factors for development of delirium among oncology patients. Gen Hosp Psychiatry 25:345–352PubMedCrossRef Ljubisavljevic V, Kelly B (2003) Risk factors for development of delirium among oncology patients. Gen Hosp Psychiatry 25:345–352PubMedCrossRef
10.
go back to reference Sagawa R, Akechi T, Okuyama T, Uchida M, Furukawa TA (2009) Etiologies of delirium and their relationship to reversibility and motor subtype in cancer patients. Jpn J Clin Oncol 39:175–182PubMedCrossRef Sagawa R, Akechi T, Okuyama T, Uchida M, Furukawa TA (2009) Etiologies of delirium and their relationship to reversibility and motor subtype in cancer patients. Jpn J Clin Oncol 39:175–182PubMedCrossRef
12.
go back to reference Riquelme R, Torres A, el-Ebiary M, Mensa J, Estruch R, Ruiz M et al (1997) Community-acquired pneumonia in the elderly. Clinical and nutritional aspects. Am J Respir Crit Care Med 156:1908–1914PubMed Riquelme R, Torres A, el-Ebiary M, Mensa J, Estruch R, Ruiz M et al (1997) Community-acquired pneumonia in the elderly. Clinical and nutritional aspects. Am J Respir Crit Care Med 156:1908–1914PubMed
13.
go back to reference Gaudreau JD, Gagnon P, Harel F, Roy MA, Tremblay A (2005) Psychoactive medications and risk of delirium in hospitalized cancer patients. J Clin Oncol 23:6712–6718PubMedCrossRef Gaudreau JD, Gagnon P, Harel F, Roy MA, Tremblay A (2005) Psychoactive medications and risk of delirium in hospitalized cancer patients. J Clin Oncol 23:6712–6718PubMedCrossRef
Metadata
Title
Impact of pneumonia on hyperactive delirium in end-stage lung cancer patients
Authors
Hidekazu Suzuki
Tomonori Hirashima
Masashi Kobayashi
Norio Okamoto
Yuka Matsuura
Motohiro Tamiya
Naoko Morishita
Kohei Okafuji
Takayuki Shiroyama
Osamu Morimura
Satomu Morita
Ichiro Kawase
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 1/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1522-8

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