We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Delirium as a Predictor of Survival in Older Patients With Advanced Cancer

Tiziana Metitieri, PhD; Angelo Bianchetti, MD; Marco Trabucchi, MD
Arch Intern Med. 2000;160(18):2866-2868. doi:.
Text Size: A A A
Published online


In a recent article, Lawlor et al1 reported a prospective study of delirium in patients with advanced cancer who were referred to an acute palliative care unit. They found terminal delirium in 46 of 52 patients who died in the hospital and poorer survival rates for delirium patients compared with controls.

We studied the occurrence of delirium in a sample of 60 older terminally ill patients admitted to the Hospice Care Unit of the Ancelle della Carità Hospital, Cremona, Italy. The overall mean ± SD age was 73.6 ± 8.3 years, and 28 (47%) were women. On admission, the mean ± SD number of symptoms was 6.2 ± 2.0, the most common symptoms being anorexia (88%), pain (64%), depression (56%), and urinary incontinence (54%). The mean ± SD Karnofsky index score at admission was 36.9 ± 12.9. Patients were assessed using the Mini-Mental State Examination within 2 days of admission, and the diagnosis of cognitive impairment was based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.2 In this sample, 17 patients (28%) had delirium, and dementia was observed in 29 patients (48%).

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience
Agitation and Delirium at the End of Life: "We Couldn't Manage Him"

Care at the Close of Life: Evidence and Experience
Delirium, Cognitive Dysfunction, and Fatigue