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Predictors of mortality for delirium in palliative care

Journal Article


Abstract


  • Introduction: Delirium has a high mortality rate. Understanding predictors of prognosis in patients with delirium will aid treatment decisions and communication. This study aimed to explore variables associated with death during an established episode of delirium in palliative care when haloperidol treatment had been commenced. Methods: A consecutive cohort of palliative care patients, from 14 centers across four countries, is reported. The outcome of interest was death within 14 days from commencement of haloperidol treatment for delirium. Clinicodemographic variables explored were delirium severity, age, gender, primary life limiting illness, body mass index (BMI), total daily haloperidol dose at baseline (mg), functional status, and comorbidities. Results: One hundred and sixteen palliative care patients where vital status was known were included in the analysis; 45% (n = 52) died within 10 days, and 56% (n = 65) died within 14 days. In multivariate analyses no clinical or demographic variables predicted death, apart from lower BMI in noncancer patients. Conclusion: This study has shown a very high mortality rate within two weeks of commencing haloperidol for delirium in palliative care, with no clear clinical predictors for those with a higher chance of dying. Having a higher BMI offered some benefit in survival, but only in noncancer patients. When delirium occurs in advanced illness, discussion should be initiated about the gravity of the clinical situation.

Publication Date


  • 2016

Citation


  • Agar, M. R., Quinn, S. J., Crawford, G. B., Ritchie, C. S., Phillips, J. L., Collier, A., & Currow, D. C. (2016). Predictors of mortality for delirium in palliative care. Journal of Palliative Medicine, 19(11), 1205-1209. doi:10.1089/jpm.2015.0416

Scopus Eid


  • 2-s2.0-84994408875

Start Page


  • 1205

End Page


  • 1209

Volume


  • 19

Issue


  • 11

Place Of Publication


Abstract


  • Introduction: Delirium has a high mortality rate. Understanding predictors of prognosis in patients with delirium will aid treatment decisions and communication. This study aimed to explore variables associated with death during an established episode of delirium in palliative care when haloperidol treatment had been commenced. Methods: A consecutive cohort of palliative care patients, from 14 centers across four countries, is reported. The outcome of interest was death within 14 days from commencement of haloperidol treatment for delirium. Clinicodemographic variables explored were delirium severity, age, gender, primary life limiting illness, body mass index (BMI), total daily haloperidol dose at baseline (mg), functional status, and comorbidities. Results: One hundred and sixteen palliative care patients where vital status was known were included in the analysis; 45% (n = 52) died within 10 days, and 56% (n = 65) died within 14 days. In multivariate analyses no clinical or demographic variables predicted death, apart from lower BMI in noncancer patients. Conclusion: This study has shown a very high mortality rate within two weeks of commencing haloperidol for delirium in palliative care, with no clear clinical predictors for those with a higher chance of dying. Having a higher BMI offered some benefit in survival, but only in noncancer patients. When delirium occurs in advanced illness, discussion should be initiated about the gravity of the clinical situation.

Publication Date


  • 2016

Citation


  • Agar, M. R., Quinn, S. J., Crawford, G. B., Ritchie, C. S., Phillips, J. L., Collier, A., & Currow, D. C. (2016). Predictors of mortality for delirium in palliative care. Journal of Palliative Medicine, 19(11), 1205-1209. doi:10.1089/jpm.2015.0416

Scopus Eid


  • 2-s2.0-84994408875

Start Page


  • 1205

End Page


  • 1209

Volume


  • 19

Issue


  • 11

Place Of Publication