Prevalence and risk factors of delirium in a sample of elderly patients receiving palliative care in Egypt

Background: Delirium is a clinical disorder that usually develops in the elderly population. It is a common issue in elderly patients receiving palliative care. This study aimed to detect the prevalence of delirium in elderly patients admitted to the palliative care unit of Geriatrics Hospital in Ain-Shams University Hospitals, using the Diagnostic and Statistical Manual of Mental Health (DSM-5) criteria, and detecting its risk factors. Patients and methods: This cross-sectional study was conducted on 85 elderly patients over the age of 60, who were consecutively admitted to the palliative care unit of Geriatrics Hospital in Ain-Shams University Hospitals. A comprehensive Geriatric Assessment was done for each participant, and then an assessment of delirium was done by DSM-5 criteria. Results: 34 (40%) of the participants were delirious, while 51 (60%) were not. 30 (88.2%) of the delirious patients were cancer patients, while 4 (11.8%) were neurodegenerative disease patients (late dementia). In the multivariate regression analysis, Charlson Comorbidity Index > 14 (p = 0.062), congestive heart failure (p = 0.028), dyspnea (p = 0.048), and Hospital Anxiety and Depression score > 14 (p = 0.01), showed correlation with delirium. In the Univariate regression analysis, hepatocellular cancer (p = 0.01), pneumonia (p = 0.095), chronic liver disease (p = 0.005), history of stroke (p = 0.001), number of medications > 4 (p = 0.002), and cognitive impairment (p = 0.043), showed correlation with delirium. Conclusions: Delirium is a prevalent disorder among elderly patients receiving palliative care. Furthermore, chronic liver disease, hepatocellular cancer, history of stroke, congestive heart failure, dyspnea, number of medications > 4, depression, Charlson Comorbidity Index > 14, and pneumonia are significant risk factors for delirium.