Evidence map›Paper›PMID 30334235›Full record

ArticleInternal and emergency medicine2019

Symptom expression in advanced cancer patients admitted to hospice or home care with and without delirium.

Sebastiano Mercadante, Francesco Masedu, Marco Maltoni, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Domenico Russo, Laura Ursini, Franco Marinangeli and 1 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Internal and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04750395 (Open-label Randomized Controlled Trial of Oral Transmucosal Haloperidol and Olanzapine in the Treatment of Terminal Delirium), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04750395 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

Open-label Randomized Controlled Trial of Oral Transmucosal Haloperidol and Olanzapine in the Treatment of Terminal Delirium

TypeinterventionalSponsorHCA Hospice CareRan2021 to 2024Enrolled80ConditionsDelirium, Terminal IllnessArmsHaloperidol Solution, Olanzapine Tablets
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Sebastiano MercadanteAnesthesia and Intensive Care and Pain relief and supportive/Palliative Care, La Maddalena Cancer Center, Via San Lorenzo 312, 90145, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
Francesco MaseduDepartment of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy.
Marco MaltoniPalliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy.
Daniela De GiovanniPalliative Care Unit, ASL Alessandria, Casale Monferrato, Italy.
Luigi MontanariPalliative Care Unit, AUSL Della Romagna, Ravenna, Italy.
Cristina PittureriPalliative Care and Hospice Unit, AUSL Romagna, Cesena, Italy.
Raffaella BertèPalliative Care, Oncology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Domenico Russo"San Marco" Hospice and Palliative Care, Latina, Italy.
Laura Ursini"Casa Margherita" Hospice, ASL 01, Avezzano-Sulmona-L'Aquila, L'Aquila, Italy.
Franco MarinangeliAnesthesiology and Pain Medicine, Department of Life Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Federica AielliDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
University of L'Aquila · ITAzienda Unità Sanitaria Locale Della Romagna · ITAzienda Sanitaria Locale Alessandria · ITGuglielmo da Saliceto Hospital · ITIstituti di Ricovero e Cura a Carattere Scientifico · ITLa Maddalena · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of this study is to investigate the relationship between delirium and symptom expression in advanced cancer patients admitted to palliative care services. This is a secondary analysis of a consecutive sample of advanced cancer patients who were admitted to home care and hospices, and prospectively assessed for a period of 10 months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after seven days of home care or hospice care (T7). Of the eight hundred and forty-eight patients screened in the period, 585 were not considered in the analysis for various reasons. The mean age was 72.1 years (SD 13.7), and 146 patients were males (55.5%). The mean Karnofsky status recorded at T0 is 34.1 (SD = 6.69). The mean duration palliative care assistance is 38.4 days (SD = 48, range 2-220). Of 263 patients who had a MDAS available at T0, 110 patients (41.8%) had a diagnosis of delirium. Of them, 167 patients had complete data regarding MDAS measurement, either at T0 and T7. A larger number of patients (n 167, 63.5%) had delirium after a week of palliative care. Patients with delirium are likely to be older, to have a lower Karnofsky level at T0, and to be home care patients. At T0, weakness, nausea, drowsiness, lack of appetite, and well-being are associated with delirium. At T7, weakness, poor appetite, and poor well-being are significantly associated with delirium. 27% of patients who had a normal cognitive status at T0 developed delirium at T7. In patients with delirium, an improvement in the cognitive status corresponds to a significant improvement in weakness, depression, and appetite. Conversely, the occurrence of delirium in patients who had a normal cognitive status at admission significantly increases the level depression, while the level of weakness and appetite decrease. Symptom expression is amplified in patients with delirium admitted to home care or hospices, while patients without delirium can be more responsive to palliative treatments with a significant decrease in intensity of ESAS items.

Indexed as

SyndromeAgedAged, 80 and overAnalysis of VarianceFemaleHospice CareHospitalizationHumansMaleMiddle AgedNeoplasmsAdvanced cancerDeliriumEdmonton Symptom Assessment ScaleMemorial Delirium Assessment ScalePalliative care

Identifiers

PMID30334235
OpenAlexW2897080547

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.