ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Prevalence, associated factors, and prognostic impact of delirium in advanced cancer patients in acute palliative care units: a prospective observational study.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
contextDelirium is a frequent neuropsychiatric syndrome in patients with advanced cancer, particularly in acute palliative care settings, where its prevalence, reversibility, and prognostic implications remain incompletely characterized.
objectivesTo determine the prevalence of delirium in acute palliative care units (PCUs), identify associated clinical factors, evaluate reversibility, and assess its impact on overall survival (OS) in patients with advanced cancer.
methodsA prospective, longitudinal, observational study was conducted in acute PCUs at two tertiary hospitals. Adult patients with advanced cancer were assessed at admission and every 5 ± 2 days. Delirium was diagnosed according to DSM-5 criteria using the Memorial Delirium Assessment Scale (MDAS; cutoff ≥ 7). Univariate analyses were performed to explore associations with clinical variables. Overall survival was analyzed using Kaplan-Meier methods and Cox regression.
resultsAmong 355 eligible admissions, delirium occurred in 28% of patients, with 82% identified at admission. The hypoactive subtype was predominant, and reversibility was observed in 16%. Advanced age and poor functional status were significant predisposing factors, while infection, insomnia, fever, dehydration, immobility, and hypoglycemia were associated conditions. Median OS was significantly shorter in patients with delirium (24.5 95%CI 15-43 vs. 52 days, 95%CI 47-63). In unadjusted analyses, delirium was associated with increased mortality (HR = 1.51; 95%CI 1.19-1.92; p < 0.001). However, this association did not remain statistically significant after multivariable adjustment (adjusted HR = 1.28; 95%CI 0.98-1.66; p = 0.068).
conclusionsDelirium affected one in four patients admitted to acute PCUs, showed limited reversibility, and was associated with reduced survival. These findings highlight delirium as a frequent and clinically meaningful syndrome and underscore the importance of systematic screening and early, proactive management in acute palliative care.
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