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Assessment of delirium in advanced cancer: The use of the bedside confusion scale

Harry R. Horvitz Center for Palliative Medicine (a World Health Organization Demonstration Project in Palliative Medicine), Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio

Declan Walsh, MSc, FACP, FRCP (Edin)

Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio

Kristine A. Nelson, MD

Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio

Susan LeGrand, MD

Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio

Mellar P. Davis, MD, FCCP

The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio

We conducted a prospective assessment of 50 consecutive admissions to an acute palliative medicine unit, using the bedside confusion scale (BSCS). Information including age, gender, diagnosis, and the presence or absence of brain metastasis was collected. Possible predisposing factors for delirium were recorded. Forty-one of 50 consecutive admissions were screened. There were 18 men and 23 women with a median age of 65 years (average: 60-75). The most common diagnoses among all were lung and breast cancer. Thirteen patients were delirious (BSCS score of ³ 2), 10 borderline (BSCS score = 1), and 21 normal (BSCS score = 0). Brain metastases and drugs appeared to be the most common predisposing factors of delirium. Forty percent of those that were delirious received haloperidol as symptomatic treatment. The BSCS is simple, portable, valid, quick, and easy to use by any medical team member. Delirium is common in hospitalized patients with advanced cancer.

Key Words: acute confusional state • advanced cancer • bedside confusion scale (BSCS) • delirium • haloperidol • symptom management

American Journal of Hospice and Palliative Medicine®, Vol. 18, No. 5, 335-341 (2001)
DOI: 10.1177/104990910101800509


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