Assessing Delirium and Fall Incidence in Palliative Care Patients: A Study Using the 4AT Tool

Author : Dr. Jacinta Marie Lopez

Abstract :Introduction: Delirium is often under-recognized in inpatient palliative care, with prevalence rates ranging from 42% to 58%. This study aimed to explore the relationship between delirium, as measured by the 4 ‘A’s Test (4AT) tool, and fall rates in a palliative care unit. Methods: A retrospective cohort observational study was conducted at Golf Links Road Palliative Care Unit, Victoria, between January 1, 2022, and January 1, 2023. Data was collected from 221 patients, including demographic details, 4AT scores, and fall incidents. Statistical analyses included chi-square tests, t-tests, and multivariable regression analysis to assess differences in fall rates based on varying 4AT scores. Results: Of the 267 patients, 174 (65%) completed the 4AT assessments. Delirium prevalence was found to be 42%. While 27 patients experienced 39 falls in total, no significant differences in fall rates were observed across the 4AT score categories. Patients with higher 4AT scores had lower Australia-modified Karnofsky Performance Status (AKPS) scores, indicating greater functional impairment. Interestingly, those with 4AT scores between 4-8 had the highest fall rates and longer hospital stays compared to those with negative and strongly positive scores. Conclusion: This study did not find a statistically significant link between 4AT scores and fall rates in palliative care. However, higher 4AT scores were associated with decreased functional independence, highlighting the importance of routine delirium assessments for better care planning

Keywords :Delirium, 4AT tool, palliative care, fall rates, functional impairment, AKPS, hospital stay

Conference Name :International Conference on Oncology Treatment and Radiology (ICOTR-25)

Conference Place Hai Phong, Vietnam

Conference Date 9th Apr 2025