Background. Delirium is a common neuropsychiatric condition seen in patients with severe illness, such as advanced cancer. Few published studies are available of the frequency, course, and outcomes of standardized management of delirium in advanced cancer patients admitted to acute palliative care unit (APCU). In this study, we examined the frequency, characteristics, and outcomes of delirium in patients with advanced cancer admitted to an APCU. Methods. Medical records of 609 consecutive patients admitted to the APCU from January 2011 through December 2011 were reviewed. Data on patients’ demographics; Memorial Delirium Assessment Scale (MDAS) score; palliative care specialist (PCS) diagnosis of delirium; delirium etiology, subtype, and reversibility; late development of delirium; and discharge outcome were collected. Delirium was diagnosed with MDAS score ≥7 and by a PCS using Diagnostic and Statistical Manual, 4th edition, Text Revision criteria. All patients admitted to the APCU received standardized assessments and management of delirium per best practice guidelines in delirium management. Results. Of 556 patients in the APCU, 323 (58%) had a diagnosis of delirium. Of these, 229 (71%) had a delirium diagnosis on admission and 94 (29%) developed delirium after admission to the APCU. Delirium reversed in 85 of 323 episodes (26%). Half of patients with delirium (n = 162) died. Patients with the diagnosis of delirium had a lower median overall survival than those without delirium. Patients who developed delirium after admission to the APCU had poorer survival (p ≤ .0001) and a lower rate of delirium reversal (p = .03) compared with those admitted with delirium. Conclusion. More than half of the patients admitted to the APCU had delirium. Reversibility occurred in almost one‐third of cases. Diagnosis of delirium was associated with poorer survival. Implications for Practice: Delirium is the most common neuropsychiatric condition in patients with severe medical illness and those at the end of life. It can be a source of distress for patients, their families, and the medical team. When missed, or if symptoms are misinterpreted, delirium may also lead to unnecessary interventions. This underlines the importance of diagnosis and detection of delirium in populations that are at increased risk. This study has important implications in practice, as it can assist clinicians in making decisions regarding other medical interventions, advance care planning, and communicating with families relating to end‐of‐life issues.

158 Background: Delirium is a common neuropsychiatric condition seen in patients (pts) with severe illness such as advanced cancer. Few studies on delirium frequency and course had been undertaken in pts with advanced cancer. We aimed to determine the frequency, characteristics and outcomes of pts with advanced cancer admitted to an APCU. Methods: Medical records of 609 consecutive pts admitted to the acute palliative care unit from January 2011-December 2011 were retrospectively reviewed. Demographics, Memorial Delirium Assessment Scale (MDAS), Palliative Medicine specialist (PMS) diagnosis of delirium, delirium etiology, subtype, reversibility, late development of delirium, and discharge outcome were collected. Delirium was diagnosed with MDAS score > 7 or by a PMS using DSM-IV TR Criteria. All pts admitted to the APCU had standardized assessments and management of delirium per best practice guidelines in delirium management. Descriptive statistics were used. Results: 317/609 (52%) APCU pts had a diagnosis of delirium; 214/317 (67%) on admission and 103/317 (33%) developed delirium after admission to the APCU. Hyperactive delirium was the most frequent type of delirium 117/317 (37%) followed by hypoactive 101/317 (32%) and mixed type 91/317 (29%). Haloperidol was the most commonly used medication to treat symptoms of delirium 210/317 (66%) followed by chlorpromazine 61/317 (19%). The use of olanzapine, lorazepam and other antipsychotics were minimal. Other interventions included opioid rotation 55/119 (46%), hydration 10/119 (8%), antibiotics 2/119 (2%) and combination treatment of opioid rotation, hydration, correction of electrolytes and antibiotics 52/119 (44%). Counseling of the caregivers and patient when indicated was performed in all cases. Delirium reversed in 98/317 (31%) of episodes. The majority of pts with delirium were discharged to hospice 130/317 (41%). Conclusions: About half of the pts admitted to the APCU had delirium. The predominant type was hyperactive delirium. Reversibility occurred in only a third of cases. Haloperidol was the main pharmacological agent. Pts with delirium were more frequently discharged to hospice.