Hoogendoorn, Fabienne (2026) When the Brain Falters: Delirium as a Frequent, Multifactorial and Consequential Complication in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation for Hematological Diseases. thesis, Medicine.
Full text available on request.Abstract
Background: Delirium is a frequent but underdiagnosed complication following allogeneic hematopoietic stem cell transplantation (alloHSCT), especially in older patients. This study aimed to determine the prevalence and associated risk factors of delirium after alloHSCT. Additionally, the association of delirium with severity of inflammation and hematopoietic recovery were investigated. Methods: In this retrospective single-center cohort study of 560 patients aged >50 years, presence of delirium and subsyndromal delirium was identified using validated chart review, based on the DSM-5 criteria for delirium. Subsyndromal delirium was defined as the presence of fewer than three symptoms included in the DSM-5 diagnostic criteria. Prevalence, risk factors, severity of inflammation (indicated by C-reactive protein [CRP]), and long-term outcomes, including hematopoietic recovery (assessed using serial blood counts), were analyzed. Results: Delirium and subsyndromal delirium occurred in 15.5% and 4.3% of patients, respectively. Higher age, reduced functional status, higher number of treatment-related complications, and increased medication exposure were independently associated with delirium, supporting a multifactorial vulnerability model. Longitudinal CRP trajectories were not associated with delirium, whereas differences in hemoglobin, thrombocyte, and leukocyte recovery suggested altered hematopoietic reconstitution after delirium. Moreover, delirium was significantly associated with prolonged hospitalization, more frequent ICU admission, increased readmissions, and mortality. Conclusions: Delirium has a relatively high prevalence in alloHSCT patients and reflects a state of clinical vulnerability and complex post-transplant recovery. Given its frequent association with adverse outcomes, these findings highlight the need for systematic awareness, early detection that would enable timely prevention, and risk stratification in routine clinical care
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Trzpis, Monika |
| Faculty: | Medical Sciences |
| Date Deposited: | 28 Oct 2026 14:13 |
| Last Modified: | 28 Oct 2026 14:13 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3987 |
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