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KMID : 0856920140170030170
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Journal of Hospice and Palliative Care
2014 Volume.17 No. 3 p.170 ~ p.178
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Risk Factors Related to Development of Delirium in Hospice Patients
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Koh Hae-Jin
Youn Chang-Ho
Chung Seung-Eun
Kim A-Sol
Kim Hyo-Min
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Abstract
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Purpose: Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients.
We investigated risk factors related to the development of delirium among hospice care patients.
Methods: Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests
performed at the time of patient’s admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox’s proportional hazard model was performed using significant factors of logistic regression analysis.
Results: Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE＜24), depression (BDI≥16), and insomnia (ISI≥15) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009∼13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009∼13.097) were found significant using Cox’s proportional hazard model.
Conclusion: The development of delirium was significantly related to depression and cognitive impairment among
patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.
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KEYWORD
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Cognitive disorders, Delirium, Depression, Hospice care
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