Mihara Noriaki, Yazawa Yasuo, Imanishi Jungo, Torigoe Tomoaki, Onishi Hideki, Ishida Mayumi
Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan.
Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
BMJ Support Palliat Care. 2023 Sep 11;14(e2). doi: 10.1136/spcare-2023-004544.
Delirium, a neurocognitive disorder, typically occurs in older patients and those with advanced cancer. Although there have been numerous reports on delirium in patients with cancer in various conditions, there are no reports that specifically focus on patients with musculoskeletal tumours. This prospective study aimed to investigate the incidence, risk factors and prognostic implications of delirium in patients with musculoskeletal tumours.
In this single institutional study, 148 patients with musculoskeletal oncology were enrolled. The estimated risk factors included age, sex, alcohol abuse, performance status (PS), dietary status, admission route, tumour malignancy, oncological stage and blood test results. The significance of delirium in survival was also examined.
Only 18 patients with malignant tumours had delirium (12.2%). Based on univariate analysis, older age, poor PS, dietary status, admission from another hospital, malignant tumour, carcinoma rather than sarcoma, anaemia and some laboratory abnormalities were found to be significant risk factors for delirium. Multivariate analysis showed that poor PS was significantly correlated with delirium. Additionally, delirium was significantly correlated with poor survival.
The incidence of delirium among patients with musculoskeletal tumours was 12.2% and was observed only in patients with malignant tumours. PS is a significant risk factor for delirium. Delirium is correlated with poor prognosis.
谵妄是一种神经认知障碍，通常发生在老年患者和晚期癌症患者中。尽管已有众多关于各种情况下癌症患者谵妄的报道，但尚无专门针对肌肉骨骼肿瘤患者的报道。这项前瞻性研究旨在调查肌肉骨骼肿瘤患者谵妄的发生率、危险因素及预后影响。
在这项单机构研究中，纳入了148例肌肉骨骼肿瘤患者。估计的危险因素包括年龄、性别、酗酒、体能状态（PS）、饮食状况、入院途径、肿瘤恶性程度、肿瘤分期及血液检查结果。还检查了谵妄对生存的意义。
仅18例恶性肿瘤患者发生谵妄（12.2%）。单因素分析显示，年龄较大、PS较差、饮食状况、从其他医院转入、恶性肿瘤、癌而非肉瘤、贫血及一些实验室异常是谵妄的显著危险因素。多因素分析表明，PS较差与谵妄显著相关。此外，谵妄与生存较差显著相关。
肌肉骨骼肿瘤患者中谵妄的发生率为12.2%，且仅在恶性肿瘤患者中观察到。PS是谵妄的一个重要危险因素。谵妄与预后较差相关。
