Evidence map›Paper›PMID 34177228›Full record

ArticleFederal practitioner : for the health care professionals of the VA, DoD, and PHS2021

Risk Factors and Antipsychotic Usage Patterns Associated With Terminal Delirium in a Veteran Long-Term Care Hospice Population.

Emily M Ellsworth, Kevin J Bacigalupo, Kavita R Palla, Seema S Limaye, Margaret J Walkosz, Sandra T Szczecinski, Katie J Suda

Open access · bronzeAbstract read
In one paragraph

Article in Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 39% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 5 citations in OpenAlex.

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  4. Review
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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

7 authors at 1 institution in 1 country.

Emily M Ellsworthand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Kevin J Bacigalupoand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Kavita R Pallaand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Seema S Limayeand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Margaret J Walkoszand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Sandra T Szczecinskiand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
Katie J Sudaand are Clinical Pharmacy Specialists in Geriatrics; is the Director of Hospice and Palliative Medicine; is a Nurse Practitioner in Hospice and Palliative Care; and is the Nursing Manager of the Hospice and Palliative Care Unit; all at Edward Hines, Jr. Veterans Affairs (VA) Hospital. is a Research Health Scientist, Associate Director of Clinical Therapeutics, Center for Health Equity Research and Promotion at VA Pittsburgh Healthcare System and Professor of Medicine at University of Pittsburgh Division of General Internal Medicine both in Pennsylvania.
VA Pittsburgh Healthcare System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe development of delirium is very common in terminally ill patients. However, risk factors for terminal delirium in the veteran population are poorly identified. The purpose of this study was to (1) Identify risk factors for terminal delirium in a US Department of Veterans Affairs inpatient hospice population; (2) Assess usage patterns of antipsychotics for treatment of terminal delirium; and (3) Describe nursing assessment, nonpharmacologic interventions, and documentation of terminal delirium.

methodsThis was a retrospective case-control study of veterans who expired while admitted into hospice care at a long-term care hospice unit during the period of October 1, 2013 to September 30, 2015. Veterans' medical records were reviewed for the 2 weeks prior to the recorded death.

resultsOf 307 veterans admitted for hospice care, 67.4% required antipsychotics in the last 2 weeks of life for the treatment of terminal delirium. The average number of antipsychotic doses given was 14.9 doses per patient. The risk factors that were identified included the use of steroids, opioids, or anticholinergics; Vietnam-era veterans with liver disease; veterans with cancer and a comorbid mental health disorder; and veterans with a history of drug and/or alcohol abuse.

conclusionsMore than half of veterans admitted for hospice care experienced terminal delirium requiring treatment with antipsychotics. The identification of veterans most likely to develop terminal delirium will allow for early nonpharmacologic interventions and potentially decrease the need for treatment with antipsychotic medications.

Identifiers

PMID34177228
PMCPMC8221829
OpenAlexW3165440718

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.