Impact of delirium on the short term prognosis of advanced cancer patients

Caraceni, Augusto; Nanni, Oriana; Maltoni, Marco; Piva, L; Indelli, Monica; Arnoldi, Ermenegildo; Monti, Massimo; Montanari, Luigi; Amadori, Dino; Conno, F. De

doi:10.1002/1097-0142(20000901)89:5<1145::aid-cncr24>3.0.co;2-x

Cited by 184 publications

(135 citation statements)

References 21 publications

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“…PPI is scored using presentations of clinical symptoms only (performance status, dyspnea, oral intake, edema and delirium) without CPS or laboratory tests (Morita et al, 1999). Both scores had been validated in various hospice settings with acceptable sensitivity and specificity for end-of-life prediction (Maltoni et al, , 2001(Maltoni et al, , 2012Caraceni et al, 2000;Glare et al, 2001;Stone et al, 2008;Stiel et al, 2010;Yoong et al, 2010;Alshemmari et al, 2012). One study from Germany compared PaP score, PPI and CPS in terminally ill patients.…”

Section: Introductionmentioning

confidence: 99%

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

Cheng¹,

Kao²,

Hung³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

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Section: Introductionmentioning

confidence: 99%

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

Cheng¹,

Kao²,

Hung³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…5 In patients with advanced cancer, delirium is associated with decreased survival. 6,7 Patients with delirium, based on their increased likelihood of being discharged to a facility rather than home, 8 are less likely to be able to care for themselves. Because delirium can impair patient capacity, caregivers may take a more active role in medical decision-making for patients with delirium.…”

Section: Introduction Dmentioning

confidence: 99%

Associations between Caregiver-Perceived Delirium in Patients with Cancer and Generalized Anxiety in their Caregivers

Buss

Vanderwerker

Inouye

et al. 2007

Journal of Palliative Medicine

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Background: Delirium, a common complication of advanced cancer, may put caregivers at risk for poor mental health outcomes. We looked for a relationship between caregiver-perceived delirium in a patient with advanced cancer and rates of caregiver psychiatric disorders.Methods: Using cross-sectional data from 200 caregivers of patients with cancer with a life expectancy of less than 6 months, we determined the frequency of caregiver-perceived delirium, which was defined as caregivers who reported witnessing the patient "confused, delirious" on the Stressful Caregiving Response to Experiences of Dying (SCARED) weekly or more often. We tested for associations between caregiver-reported delirium and presence of caregiver mental disorders, using the Structured Clinical Interview for the DSM-IV to diagnose mental disorders and caregiver burden, as measured by the caregiver burden scale (CBS).Results: Of the 200 caregivers who completed the SCARED, 38 (19.0%) reported seeing the patient "confused, delirious" at least once per week in the month prior to study enrollment and 7 (3.5%) met criteria for generalized anxiety (GA). Caregivers of patients with caregiver-perceived delirium were 12 times more likely to have GA (odds ratio [OR] ‫؍‬ 12.12; p Ͻ 0.01). The relationship between caregiver-perceived delirium and caregiver GA persisted after adjusting for caregiver burden and exposure to other stressful patient experiences (OR ‫؍‬ 9.99; p ‫؍‬ 0.04).Conclusions: This is the first report of an association between caregiver-perceived delirium and a caregiver mental health outcome. Further studies, using improved measures of delirium, are needed.

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“…Performance status [22][23][24], dyspnea [25,26], malnutrition [27,28], appetite/weight loss [29], and delirium [30,31] are well-known clinical factors. Recently, novel prognostic factors have been proposed.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Prognosis Prediction Models and their Clinical Utility in Palliative Care

Uneno¹,

Kanai²

2017

Highlights on Several Underestimated Topics in Palliative Care

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Prognosis prediction is a clinically relevant issue to facilitate optimal decision-making for both physicians and patients with cancer. Many previous studies revealed that prognosis prediction based on the physician's intuition and/or clinical experience is inaccurate and often optimistic, which means that there is a tendency to overestimate patient survival in daily clinical practice. In recent decades, many eforts have been made to develop prognosis prediction models which aid physicians to make more accurate prognosis prediction. In this chapter, we review the representative prognosis prediction models in palliative care and related studies. In addition, we refer to several prognosis prediction models developed by unique methods (for instance, case-crossover design or machine learning). Finally, we focus on the possible clinical utility of prognosis prediction models. In fact, no previous studies have clearly demonstrated whether the application of such prognosis prediction models truly beneits patient care in daily clinical practice.Therefore, we will discuss how the application of prognosis prediction models could beneit patients under palliative care.

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Impact of delirium on the short term prognosis of advanced cancer patients

Cited by 184 publications

References 21 publications

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

Associations between Caregiver-Perceived Delirium in Patients with Cancer and Generalized Anxiety in their Caregivers

Prognosis Prediction Models and their Clinical Utility in Palliative Care

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