title: Impact of delirium on distress, health-related quality of life, and cognition 6 months and 1 year after hematopoietic cell transplant.
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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington 98125, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Basinski
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003693:Delirium / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000523:psychology / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000523:psychology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology; D010051:Ovarian Neoplasms / Q000523:psychology / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult