Risk factors for delirium among patients with advanced cancer in palliative care: a multicenter, patient-based registry cohort in South Korea

OBJECTIVE: Previous studies have comprehensively investigated the preva-lence and various potential risk factors for de-lirium among patients with advanced cancer ad-mitted to the acute palliative care unit (APCU). Our objective was to evaluate the comprehen-sive association between delirium and various risk factors among patients with advanced can-cer in an acute palliative care setting using a pa-tient-based multicenter registry cohort.PATIENTS AND METHODS: We performed a multicenter, patient-based registry cohort study collected in South Korea between January 1, 2019, and December 31, 2020. Delirium was identified using a medical record review based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.RESULTS: In total, 2,124 eligible patients with advanced cancer in the APCU met the inclu-sion criteria. There were 127 out of 2,124 pa-tients (prevalence, 6.0%; 95% CI, 5.0 to 7.1) with delirium during admission. Delirium in patients with advanced cancer was associated with age >70 years (OR, 1.793; 95% CI, 1.246 to 2.581), male sex (OR, 1.675; 95% CI, 1.131 to 2.479), no chemotherapy during hospitalization (OR, 2.019; 95% CI, 1.236 to 3.298), hearing impairment (OR, 3.566; 95% CI, 1.176 to 10.810), underweight (OR, 1.826; 95% CI, 1.067 to 3.124), current use of opioid medication (OR, 1.942; 95% CI, 1.264 to 2.982), previous history of delirium (OR, 12.497; 95% CI, 6.920 to 22.568), and mental illness (OR, 2.333; 95% CI, 1.251 to 4.352).CONCLUSIONS: In a large-scale multicenter patient-based registry cohort, delirium was asso-ciated with old age, male sex, no chemotherapy during hospitalization, hearing impairment, un-derweight, current use of opioid medication, and a history of delirium and mental illness. Our find-ings suggest physicians should pay attention to delirium in patients with advanced cancer admit-ted to the APCU with the above risk factors.

Automated summary

This study aimed to evaluate the comprehensive association between delirium and various risk factors among patients with advanced cancer in an acute palliative care setting. The results showed that delirium in patients with advanced cancer was associated with age, gender, chemotherapy, hearing impairment, underweight, opioid medication, and a history of delirium and mental illness. Therefore, physicians should pay attention to delirium in patients with advanced cancer admitted to the acute palliative care unit with the above risk factors.