Hideki Onishi1, Izumi Sato2, Nozomu Uchida3, Takao Takahashi4, Daisuke Furuya5, Yasuhiro Ebihara6, Akira Yoshioka7, Hiroshi Ito8, Mayumi Ishida9. 1. Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama, 350-1298, Japan. 2. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan. 3. Department of General Medicine, Ogano Town Central Hospital, Ogano, Japan. 4. Department of Supportive Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. 5. Department of General Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. 6. Department of Laboratory Medicine, Saitama Medical University International Medical Center, Hidaka, Japan. 7. Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, Japan. 8. Ito Internal Medicine and Pediatric Clinic, Fukuoka, Japan. 9. Department of Psycho-oncology, Saitama Medical University International Medical Center, Hidaka, Japan. mayumi_i@saitama-med.ac.jp.
Abstract
BACKGROUND/ OBJECTIVES: Recent studies have revealed thiamine deficiency (TD) as a cause of delirium in cancer patients. However, the extent to which Wernicke encephalopathy is present and in what patients is not well understood. SUBJECTS/ METHODS: In this retrospective descriptive study, we investigated referred cancer patients who were diagnosed with delirium by a psycho-oncologist to clarify the proportion of TD, the therapeutic effect of thiamine administration, and the factors involved in its onset. RESULTS: Among 71 patients diagnosed with delirium by a psycho-oncologist, TD was found in 45% of the patients. Intravenous administration of thiamine led to a recovery in about 60% of these patients. We explored the factors associated with TD using a multivariable regression model with a Markov chain Monte Carlo imputation procedure. We found an association between TD and chemotherapy (adjusted odds ratio, 1.98 [95% confidence interval, 1.04-3.77]); however, there were no significant associations between TD and the other factors we considered. CONCLUSIONS: TD is not particularly rare in delirium patients undergoing psychiatric consultation. The delirium was resolved in more than half of these patients by intravenous administration of thiamine. Oncologists should consider TD as a cause of delirium in cancer patients. Further prospective study is needed to clarify the relationship between TD and delirium in cancer patients.
BACKGROUND/ OBJECTIVES: Recent studies have revealed thiaminedeficiency (TD) as a cause of delirium in cancerpatients. However, the extent to which Wernicke encephalopathy is present and in what patients is not well understood. SUBJECTS/ METHODS: In this retrospective descriptive study, we investigated referred cancerpatients who were diagnosed with delirium by a psycho-oncologist to clarify the proportion of TD, the therapeutic effect of thiamine administration, and the factors involved in its onset. RESULTS: Among 71 patients diagnosed with delirium by a psycho-oncologist, TD was found in 45% of the patients. Intravenous administration of thiamine led to a recovery in about 60% of these patients. We explored the factors associated with TD using a multivariable regression model with a Markov chain Monte Carlo imputation procedure. We found an association between TD and chemotherapy (adjusted odds ratio, 1.98 [95% confidence interval, 1.04-3.77]); however, there were no significant associations between TD and the other factors we considered. CONCLUSIONS: TD is not particularly rare in deliriumpatients undergoing psychiatric consultation. The delirium was resolved in more than half of these patients by intravenous administration of thiamine. Oncologists should consider TD as a cause of delirium in cancerpatients. Further prospective study is needed to clarify the relationship between TD and delirium in cancerpatients.
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