Prevalence of delirium among patients at a cancer ward: Clinical risk factors and prediction by
bedside cognitive tests
Sammanfattning
Background: Delirium is a frequent psychiatric complication to cancer, but rarely recognized by
oncologists. Aims: 1. To estimate the prevalence of delirium among inpatients admitted at an
oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To
examine the value of cognitive testing in the assessment of delirium. Methods: On five different
days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health
Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System
and the Confusion Assessment Method (CAM) were used for diagnostic categorization. Clinical
information was gathered from medical records and all patients were tested with Mini Cognitive Test,
The Clock Drawing Test, and the Digit Span Test. Results: 81 cancer patients were assessed and
33% were diagnosed with delirium. All delirious participants were CAM positive. Poor performance on
the cognitive tests was associated with delirium. Medical records describing CNS metastases,
benzodiazepine or morphine treatment were associated with delirium. Conclusions: Delirium is
prevalent among cancer inpatients. The Mini Cognitive Test, The Clock Drawing Test, and the Digit
Span Test can be used as screening tools for delirium among inpatients with cancer, but even in
synergy, they lack specificity. Combining cognitive testing and attention to nurses’ records might
improve detection, yet further studies are needed to create a more detailed patient profile for the
detection of delirium.