Title: 암환자 섬망의 중증도와 사망위험도의 관계

Objectives：To assess the association between severity of delirium and mortality in cancer patients and to investigate the phenomenology of delirium among those facing imminent death. Methods：We retrospectively reviewed the charts of 112 cancer patients with delirium at a cancer center. The subjects were categorized into three groups(deceased before discharge, discharged without hope for improvement, and improved). Severity of delirium was assessed using Korean version of the Delirium Rating Scale-Revised-98(K-DRS-R-98), and the scores of the three groups were compared after adjusting for the demographic and clinical factors that differed in the univariate analyses(p＜0.1). Results：Of the 112 patients, 20(17.9%) died prior to discharge, 28(25.0%) were discharged without hope for improvement, and 64(57.1%) improved during the index admission period. We found a significant difference in the total K-DRS-R-98 scores of the three groups(24.2, 26.1, and 21.2, respectively, p=0.002), which was maintained after adjusting for potential confounding factors(age, abnormality of white blood cell counts, and use of antibiotics and opioids). The total K-DRS-R-98 scores in the post-hoc analyses were significantly higher in the deceased-before-discharge and discharged-without-hope-for-improvement groups than in the improved group(p=0.017 and ＜0.001, respectively). According to scores on the K-DRS-R-98, sleep-wake cycle disturbances, language and cognitive abnormalities, and difficulties with attention, short-term memory, and visuospatial abilities were more frequent in cancer patients in the deceased-before-discharge and discharged-without-hope groups than in the improved group. Conclusion：The severity of delirium at the time of psychiatric consultation was significantly associated with mortality in cancer patients with delirium.
Objectives：To assess the association between severity of delirium and mortality in cancer patients and to investigate the phenomenology of delirium among those facing imminent death. Methods：We retrospectively reviewed the charts of 112 cancer patients with delirium at a cancer center. The subjects were categorized into three groups(deceased before discharge, discharged without hope for improvement, and improved). Severity of delirium was assessed using Korean version of the Delirium Rating Scale-Revised-98(K-DRS-R-98), and the scores of the three groups were compared after adjusting for the demographic and clinical factors that differed in the univariate analyses(p＜0.1). Results：Of the 112 patients, 20(17.9%) died prior to discharge, 28(25.0%) were discharged without hope for improvement, and 64(57.1%) improved during the index admission period. We found a significant difference in the total K-DRS-R-98 scores of the three groups(24.2, 26.1, and 21.2, respectively, p=0.002), which was maintained after adjusting for potential confounding factors(age, abnormality of white blood cell counts, and use of antibiotics and opioids). The total K-DRS-R-98 scores in the post-hoc analyses were significantly higher in the deceased-before-discharge and discharged-without-hope-for-improvement groups than in the improved group(p=0.017 and ＜0.001, respectively). According to scores on the K-DRS-R-98, sleep-wake cycle disturbances, language and cognitive abnormalities, and difficulties with attention, short-term memory, and visuospatial abilities were more frequent in cancer patients in the deceased-before-discharge and discharged-without-hope groups than in the improved group. Conclusion：The severity of delirium at the time of psychiatric consultation was significantly associated with mortality in cancer patients with delirium.