Impact of delirium on distress, health-related quality of life, and cognition 6 months and 1 year after hematopoietic cell transplant.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Volume 16, Issue 6, p.824-31 (2010)

Keywords:

2010, Adult, Anxiety, Breast Neoplasms, Center-Authored Paper, Clinical Research Division, Cognition Disorders, Delirium, Depression, Fatigue, Female, Follow-Up Studies, Graft vs Host Disease, Hematologic Neoplasms, hematopoietic stem cell transplantation, Humans, Male, Memory Disorders, Middle Aged, Mood Disorders, Ovarian Neoplasms, Psychiatric Status Rating Scales, Quality of Life, Questionnaires, Stress Disorders, Post-Traumatic, Stress, Psychological, Treatment Outcome, Young Adult

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.