Document Detail

Reversibility of delirium in terminally ill patients and predictors of mortality.
MedLine Citation:
PMID:  18755829     Owner:  NLM     Status:  MEDLINE    
In this study, factors related to reversibility and mortality in consecutive cases of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) delirium [n = 121] occurring in palliative care patients were evaluated. Delirium was assessed with the revised Delirium Rating Scale (DRS-R98) and Cognitive Test for Delirium (CTD). Patients were followed until recovery from delirium or death. In all, 33 patients (27%) recovered from delirium before death. Mean time until death was 39.7 +/- 69.8 days in patients with reversible delirium [n = 33] versus 16.8 +/- 10.0 days in those with irreversible delirium [n = 88; P < 0.01]. DRS-R98 and CTD scores were higher in irreversible delirium (P < 0.001) with greater disturbances of sleep, language, long-term memory, attention, vigilance and visuospatial ability. Irreversible delirium was associated with greater disturbance of CTD attention and higher DRS-R98 visuospatial function. Survival time was predicted by CTD score (P < 0.001), age (P = 0.01) and organ failure (P = 0.01). Delirium was not necessarily a harbinger of imminent death. Less reversible delirium involved greater impairment of attention, vigilance and visuospatial function. Survival time is related to age, severity of cognitive impairment and evidence of organ failure.
M Leonard; B Raju; M Conroy; S Donnelly; P T Trzepacz; J Saunders; D Meagher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-28
Journal Detail:
Title:  Palliative medicine     Volume:  22     ISSN:  1477-030X     ISO Abbreviation:  Palliat Med     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-07     Completed Date:  2008-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704926     Medline TA:  Palliat Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  848-54     Citation Subset:  IM    
Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland.
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MeSH Terms
Aged, 80 and over
Delirium / diagnosis,  drug therapy*,  mortality
Middle Aged
Recovery of Function*
Severity of Illness Index
Survival Rate
Terminally Ill*

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