Predictive Factors for Agitation Severity of Hyperactive Delirium in Terminally Ill Cancer Patients in a General Hospital Using Ordered Logistic Regression Analysis

To cite this article:
Yuko Kanbayashi, Yutaka Hatano, Yuzuru Hata, Tatsuya Morita, Kenji Fukui, and Toyoshi Hosokawa. Journal of Palliative Medicine. September 2013, 16(9): 1020-1025. doi:10.1089/jpm.2013.0100.

Published in Volume: 16 Issue 9: September 16, 2013
Online Ahead of Print: July 26, 2013

Journal of Palliative Medicine

Author information

Yuko Kanbayashi, PhD, JSOP,^1,2 Yutaka Hatano, MD,^2,3 Yuzuru Hata, MD,^2,3 Tatsuya Morita, MD,⁴ Kenji Fukui, MD, PhD,³ and Toyoshi Hosokawa, MD, PhD^2,5,6

¹Hospital Pharmacy, Kyoto Prefectural University of Medicine, Kyoto, Japan.

²Department of Pain Treatment and Palliative Care Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.

³Department of Psychiatry, Kyoto Prefectural University of Medicine, Kyoto, Japan.

⁴Department of Palliative and Supportive Care, Palliative Care Team, Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan

⁵Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

⁶Department of Pain Management and Palliative Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Address correspondence to:

Yuko Kanbayashi, PhD, JSOP

Department of Hospital Pharmacy

Kyoto Prefectural University of Medicine

Kawaramachi, Hirokoji, Kamigyo-ku, Kyoto 602-8566,

Japan
E-mail: ykokanba@koto.kpu-m.ac.jp

Accepted March 26, 2013

ABSTRACT

Background: Despite the fact that many cancer patients worldwide die in general hospitals, there are few reports of the analysis of delirium in terminally ill cancer patients in this setting.

Purpose: This study aimed to identify predictive factors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital.

Methods: Participants were 182 consecutively admitted terminally ill cancer patients who died in a Japanese general hospital between April 2009 and March 2011. Variables present one week before death were extracted from the clinical records for regression analysis of factors potentially related to agitation severity of delirium. The prevalence and agitation severity of delirium were evaluated retrospectively. Multivariate ordered logistic regression analysis was performed to identify predictive factors.

Results: Male sex [odds ratio (OR)=2.125, 95% confidence interval (CI)=1.111–4.067; P=0.0227]; total bilirubin (T-bil) [OR=1.557, CI=1.082–2.239; P=0.017]; antibiotics [OR=0.450, CI=0.219–0.925; P=0.0298]; nonsteroidal antiinflammatory drugs (NSAIDs) [OR=2.608, CI=1.374–4.950; P=0.0034]; and hematological malignancy [OR=3.903, CI=1.363–11.179; P=0.0112] were found to be statistically significant predictors for agitation severity of hyperactive delirium.

Conclusions: Our study indicates that male sex, T-bil, antibiotic therapy, NSAID therapy, and hematological malignancy are significant predictors for agitation severity of hyperactive delirium in terminally ill cancer patients in a general hospital setting.