Impact of Delirium on Distress, Health-related Quality of Life, and Cognition 6 Months and 1 Year After Hematopoietic Cell Transplant

Overview

Journal Biol Blood Marrow Transplant

Date 2010 Jan 27

PMID 20100587

Citations 24

Authors

James R Basinski

Catherine M Alfano

Wayne J Katon

Karen L Syrjala

Jesse R Fann

Affiliations

Soon will be listed here.

Abstract

Delirium commonly occurs during myeloablative hematopoietic cell transplantation (HCT). Little is known about how delirium during the acute phase of HCT affects long-term distress, health-related quality of life (HRQOL), and neurocognitive functioning. This prospective, cohort study examines these outcomes at 6 months and 1 year in 90 patients undergoing HCT. Patients completed a battery assessing distress, HRQOL, and subjective neuropsychological functioning before receiving their first HCT as well as at 6 months and 1 year. Patients with a delirium episode within the 4 weeks after HCT had significantly more distress and fatigue at 6 months (P < .004) and at 1 year (P < .03), compared with patients without delirium. At 1 year, patients with delirium also had worse symptoms of depression and post traumatic stress (P < .03). Patients with delirium had worse physical health on the SF-12 at 6 months (P < .03) and worse mental health on the SF-12 at 1 year (P < .03). At both 6 months and 1 year, patients with delirium after HCT reported worse memory (P < .009) and executive functioning (P < .006). Delirium during the acute phase of HCT is significantly associated with persistent distress, decreased HRQOL, and subjective neurocognitive dysfunction at both 6 months and 1 year.

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References

Levin H, High W, Goethe K, Sisson R, Overall J, Rhoades H . The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician. J Neurol Neurosurg Psychiatry. 1987; 50(2):183-93. PMC: 1031490. DOI: 10.1136/jnnp.50.2.183. View

Dolan M, Hawkes W, Zimmerman S, Morrison R, Gruber-Baldini A, Hebel J . Delirium on hospital admission in aged hip fracture patients: prediction of mortality and 2-year functional outcomes. J Gerontol A Biol Sci Med Sci. 2000; 55(9):M527-34. DOI: 10.1093/gerona/55.9.m527. View

Glymour M, Weuve J, Berkman L, Kawachi I, Robins J . When is baseline adjustment useful in analyses of change? An example with education and cognitive change. Am J Epidemiol. 2005; 162(3):267-78. DOI: 10.1093/aje/kwi187. View

Gruber-Baldini A, Zimmerman S, Morrison R, Grattan L, Hebel J, Dolan M . Cognitive impairment in hip fracture patients: timing of detection and longitudinal follow-up. J Am Geriatr Soc. 2003; 51(9):1227-36. DOI: 10.1046/j.1532-5415.2003.51406.x. View

Andrykowski M, Schmitt F, Gregg M, Brady M, Lamb D, Henslee-Downey P . Neuropsychologic impairment in adult bone marrow transplant candidates. Cancer. 1992; 70(9):2288-97. DOI: 10.1002/1097-0142(19921101)70:9<2288::aid-cncr2820700913>3.0.co;2-m. View

Davydow D . Symptoms of depression and anxiety after delirium. Psychosomatics. 2009; 50(4):309-16. DOI: 10.1176/appi.psy.50.4.309. View

Rockwood K, Cosway S, Carver D, Jarrett P, Stadnyk K, Fisk J . The risk of dementia and death after delirium. Age Ageing. 1999; 28(6):551-6. DOI: 10.1093/ageing/28.6.551. View

Seaman J, Schillerstrom J, Carroll D, Brown T . Impaired oxidative metabolism precipitates delirium: a study of 101 ICU patients. Psychosomatics. 2005; 47(1):56-61. DOI: 10.1176/appi.psy.47.1.56. View

Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M . Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Arch Intern Med. 2001; 161(8):1099-105. DOI: 10.1001/archinte.161.8.1099. View

10.

Ljubisavljevic V, Kelly B . Risk factors for development of delirium among oncology patients. Gen Hosp Psychiatry. 2003; 25(5):345-52. DOI: 10.1016/s0163-8343(03)00070-7. View

11.

Syrjala K, Langer S, Abrams J, Storer B, Sanders J, Flowers M . Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA. 2004; 291(19):2335-43. DOI: 10.1001/jama.291.19.2335. View

12.

Francis J, Kapoor W . Prognosis after hospital discharge of older medical patients with delirium. J Am Geriatr Soc. 1992; 40(6):601-6. DOI: 10.1111/j.1532-5415.1992.tb02111.x. View

13.

Thompson W . Statistical analysis of case-control studies. Epidemiol Rev. 1994; 16(1):33-50. DOI: 10.1093/oxfordjournals.epirev.a036143. View

14.

DeRogatis L, Morrow G, Fetting J, Penman D, Piasetsky S, Schmale A . The prevalence of psychiatric disorders among cancer patients. JAMA. 1983; 249(6):751-7. DOI: 10.1001/jama.249.6.751. View

15.

Ware Jr J, Kosinski M, Keller S . A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996; 34(3):220-33. DOI: 10.1097/00005650-199603000-00003. View

16.

Alexopoulos G, Kiosses D, Heo M, Murphy C, Shanmugham B, Gunning-Dixon F . Executive dysfunction and the course of geriatric depression. Biol Psychiatry. 2005; 58(3):204-10. DOI: 10.1016/j.biopsych.2005.04.024. View

17.

Trzepacz P, Baker R, Greenhouse J . A symptom rating scale for delirium. Psychiatry Res. 1988; 23(1):89-97. DOI: 10.1016/0165-1781(88)90037-6. View

18.

McCusker J, Cole M, Dendukuri N, Belzile E, Primeau F . Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. CMAJ. 2001; 165(5):575-83. PMC: 81415. View

19.

Cole M, You Y, McCusker J, Ciampi A, Belzile E . The 6 and 12 month outcomes of older medical inpatients who recover from delirium. Int J Geriatr Psychiatry. 2007; 23(3):301-7. DOI: 10.1002/gps.1878. View

20.

Julin J, van Burik J, Krivit W, Webb C, Holman C, Clark H . Ganciclovir-resistant cytomegalovirus encephalitis in a bone marrow transplant recipient. Transpl Infect Dis. 2003; 4(4):201-6. DOI: 10.1034/j.1399-3062.2002.02005.x. View