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Delirium in Hospitalized Children with Cancer: Incidence and Associated Risk Factors
Chani Traube1, Sydney Ariagno1, Francesca Thau2
1Weill Cornell Medical College, New York, NY.
Insights
Delirium is a common complication in hospitalized children with cancer, affecting 18.8% of patients. Younger age, brain tumors, surgery, and benzodiazepine use are key risk factors, increasing hospital stays.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Critical Care Medicine
Background:
- Delirium is a serious complication in hospitalized patients, particularly those with cancer.
- Understanding the incidence and risk factors for delirium in pediatric cancer patients is crucial for improving care.
Purpose of the Study:
- To determine the incidence of delirium in children with cancer.
- To identify risk factors associated with delirium in this population.
- To assess the impact of delirium on hospital length of stay.
Main Methods:
- A prospective cohort study was conducted over a 3-month period.
- Consecutive admissions to a pediatric cancer service were screened twice daily for delirium.
- Demographic and treatment data were collected from medical records.
Main Results:
- The incidence of delirium was 18.8% (35 out of 319 admissions).
- Independent risk factors included age <5 years, brain tumors, postoperative status, and benzodiazepine use.
- Delirium was associated with a significantly longer hospital stay (10 days vs. 5 days).
Conclusions:
- Delirium is a frequent complication in hospitalized pediatric cancer patients.
- Delirium is linked to increased hospital length of stay.
- Further multi-institutional studies are needed to identify modifiable risk factors and improve care.
Objective:
To assess the incidence of delirium and its risk factors in hospitalized children with cancer.
Study Design:
In this cohort study, all consecutive admissions to a pediatric cancer service over a 3-month period were prospectively screened for delirium twice daily throughout their hospitalization. Demographic and treatment-related data were collected from the medical record after discharge.
Results:
A total of 319 consecutive admissions, including 186 patients and 2731 hospital days, were included. Delirium was diagnosed in 35 patients, for an incidence of 18.8%. Risk factors independently associated with the development of delirium included age <5 years (OR = 2.6, P = .026), brain tumor (OR = 4.7, P = .026); postoperative status (OR = 3.3, P = .014), and receipt of benzodiazepines (OR = 3.7,P < .001). Delirium was associated with increased hospital length of stay, with median length of stay for delirious patients of 10 days compared with 5 days for patients who were not delirious during their hospitalization (P < .001).
Conclusions:
In this cohort, delirium was a frequent complication during admissions for childhood cancer, and was associated with increased hospital length of stay. Multi-institutional prospective studies are warranted to further characterize delirium in this high-risk population and identify modifiable risk factors to improve the care provided to hospitalized children with cancer.
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