Delirium in Cancer Patients

Stiefel, F.; Holland, Jennifer E.

doi:10.1017/s1041610291000789

Cited by 60 publications

(26 citation statements)

References 3 publications

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“…Haloperidol, a neuroleptic agent that is a potent dopamine blocker, is still the drug of choice in the treatment of delirium in the medically ill [60][61][62][63]. Haloperidol in low doses, 0.5-3 mg, is usually effective in targeting agitation, paranoia, and fear.…”

Section: Traditional Neuroleptic Agentsmentioning

confidence: 99%

Psychiatric issues in older cancer patients

Roth¹,

Modi²

2003

Critical Reviews in Oncology/Hematology

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Section: Traditional Neuroleptic Agentsmentioning

confidence: 99%

Psychiatric issues in older cancer patients

Roth¹,

Modi²

2003

Critical Reviews in Oncology/Hematology

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“…Compromised cognitive capability is an added challenge, insofar as 40% to 60% of older adults at the end-of-life experience compromised cognition (Bruera et al, 1992; Covinsky et al, 2003; Pereira et al, 1997; Radbruch et al, 2000; Stiefel & Holland, 1991) and this proportion increases to 70–83% when patients enter the final days of life (Bruera et al, 1992; Conill et al, 1997). This contributes to the issue of classifying patients at the end-of-life as vulnerable, a position that contributes to the ethical debate regarding research participation with this population.…”

Section: Introductionmentioning

confidence: 99%

Research Participation by Older Adults at End of Life: Barriers and Solutions

Mackin

Herr²,

Bergen-Jackson³

et al. 2009

Research in Gerontological Nursing

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The purpose of this paper is to elaborate upon barriers to research participation by older adults at end-of-life. We focus on the hospice setting and classify barriers to research participation into six domains:1) societal attitudes towards death; 2) research procedures; 3) health care organizations; 4) agency staff; 5) patients’ families and caregivers; and 6) patient characteristics. We characterize particular participation issues, uncertainties in participation for individuals with advanced illness, infringements upon patient self-determination, as well as, potential solutions to these research challenges. Our observation of the complex palliative context included the realization that a singular change would not have large enough impact. We concluded that simultaneous with the need to expand the research base addressing the needs of dying persons is a need to understand the challenges of implementing research projects with older persons at end-of-life.

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“…Delirium is one of the commonest psychiatric syndromes in acutely ill general medical and surgical patients and the second most common psychiatric diagnosis among hospitalized elderly cancer patients [19,22,27,42,43]. It occurs in approximately 20% of hospitalized elderly patients and may be seen in up to 50% of patients who have had surgery for hip fractures and bilateral knee replacements [45,51].…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

Olofsson

Weitzner

Valentine

et al. 1996

Support Care Cancer

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This report describes the evaluation and treatment of delirium in the cancer patient in a major comprehensive cancer center. Ninety consecutive cases of delirium seen by the inpatient psychiatry consultation/liaison service were analyzed in a retrospective fashion to evaluate demographic information, alcohol use, central nervous system disease, coexisting medical disease, and past psychiatric history. Delirium cases were divided into hyperalert, hypoalert, and mixed subtypes. For these three subtypes, medication profiles including dose of medication, duration of delirium, outcome, and the venue where the delirium began were also evaluated. The hyperalert subtype of delirium was the commonest type observed (71%) and had the shortest duration (P < 0.0001) and best outcome (P < 0.001). The patients with a hyperalert delirium subtype were treated with the least amount of haloperidol (P < 0.0001). Patients were delirious for longer when the delirium began in the intensive-care units (P < 0.04). In general, patients who received no haloperidol experienced delirium of longer duration (P < 0.02) than those receiving haloperidol. Since the data represent patients who were referred for psychiatric treatment, this may explain the increased number of hyperalert deliriums and, therefore, the generalizability of the results is limited. Delirium in the cancer patient is particularly problematic given the coexisting medical problems these patients experience. Because the outcome of delirium is better when the duration is shorter, it is important for clinicians to be sensitive to early symptoms so that treatment can be implemented faster, leading to less morbidity and mortality.

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Delirium in Cancer Patients

Cited by 60 publications

References 3 publications

Psychiatric issues in older cancer patients

Psychiatric issues in older cancer patients

Research Participation by Older Adults at End of Life: Barriers and Solutions

A retrospective study of the psychiatric management and outcome of delirium in the cancer patient

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