Valda D Page

Delirium frequency among advanced cancer patients presenting to an emergency department: A prospective, randomized, observational study

The frequency of delirium among patients with cancer presenting to the emergency department (ED) is unknown. The purpose of this study was to determine delirium frequency and recognition by ED physicians among patients with advanced cancer presenting to the ED of The University of Texas MD Anderson Cancer Center.

Poor immune reconstitution is associated with symptomatic BK polyomavirus viruria in allogeneic stem cell transplant recipients

BK polyomavirus (BKPyV) infections are known indicators of immune suppression in hematopoietic stem cell transplant (HSCT) recipients; they can lead to hemorrhagic cystitis, ureteral stenosis, renal dysfunction, and prolonged hospital stays. In this study, we determined transplant‐associated variables and immune parameters that can predict for the risk of BKPyV viruria. We hypothesized that BKPyV infection is a marker of poor immune recovery.

Delirium assessment in patients with advanced cancer presenting to the emergency department of a comprehensive cancer center.

217 Background: The exact frequency of delirium among patients with advanced cancer presenting to emergency departments (EDs) is unknown. The purpose of this study is to determine the prevalence of delirium among patients with advanced cancer who present to the ED at MD Anderson Cancer Center. METHODS The exact frequency of delirium among patients with advanced cancer presenting to emergency departments (EDs) is unknown. The purpose of this study is to determine the prevalence of delirium among patients with advanced cancer who present to the ED at MD Anderson Cancer Center. RESULTS A total of 624 patients were screen for this study, and 243 patients were enrolled. The main reasons for exclusion were: 1) cancer was not advanced, 2) the patient had been in the ED for over 12 hours and 3) the patient was non-English speaking. The median age for all patients enrolled was 62 years (range 19 - 89 years), 167 (69%) were white, and 120(49.4) were female. CAM was positive in 22(9%) of patients. The median MDAS score of CAM positive patients was 14 (range 9 - 22 out of 30). Ten (10%)of 99 patients aged 65 and older were delirious as compared to 12 (8%) of 144 patients younger than 65 years (p = 0.6). Physician correctly predicted delirium in 13 patients (59%). Among the patients who were CAM positive 18 (82%) were admitted to the hospital as compared to 115 (52%) of patients without delirium (p = 0.012). Patients with delirium had higher hospital, and six months mortality rate. CONCLUSIONS Delirium was identified in 9% of patients with advanced cancer visiting an ED, and is associated with more hospitalization and poor survival.