BACKGROUND AND PURPOSE: Delirium is common in the early stage after hospitalization for an acute stroke. We conducted a systematic review and meta-analysis to evaluate the outcomes of acute stroke patients with delirium. METHODS: We searched MEDLINE, EMBASE, CINAHL, Cochrane Library databases, and PsychInfo for relevant articles published in English up to September 2011. We included observational studies for review. Two reviewers independently assessed studies to determine eligibility, validity, and quality. The primary outcome was inpatient mortality and secondary outcomes were mortality at 12 months, institutionalization, and length of hospital stay. RESULTS: Among 78 eligible studies, 10 studies (n=2004 patients) met the inclusion criteria. Stroke patients with delirium had higher inpatient mortality (OR, 4.71; 95% CI, 1.85-11.96) and mortality at 12 months (OR, 4.91; 95% CI, 3.18-7.6) compared to nondelirious patients. Patients with delirium also tended to stay longer in hospital compared to those who did not have delirium (mean difference, 9.39 days; 95% CI, 6.67-12.11) and were more likely to be discharged to a nursing homes or other institutions (OR, 3.39; 95% CI, 2.21-5.21). CONCLUSIONS: Stroke patients with development of delirium have unfavorable outcomes, particularly higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Early recognition and prevention of delirium may improve outcomes in stroke patients.
BACKGROUND AND PURPOSE:Delirium is common in the early stage after hospitalization for an acute stroke. We conducted a systematic review and meta-analysis to evaluate the outcomes of acute strokepatients with delirium. METHODS: We searched MEDLINE, EMBASE, CINAHL, Cochrane Library databases, and PsychInfo for relevant articles published in English up to September 2011. We included observational studies for review. Two reviewers independently assessed studies to determine eligibility, validity, and quality. The primary outcome was inpatient mortality and secondary outcomes were mortality at 12 months, institutionalization, and length of hospital stay. RESULTS: Among 78 eligible studies, 10 studies (n=2004 patients) met the inclusion criteria. Strokepatients with delirium had higher inpatient mortality (OR, 4.71; 95% CI, 1.85-11.96) and mortality at 12 months (OR, 4.91; 95% CI, 3.18-7.6) compared to nondelirious patients. Patients with delirium also tended to stay longer in hospital compared to those who did not have delirium (mean difference, 9.39 days; 95% CI, 6.67-12.11) and were more likely to be discharged to a nursing homes or other institutions (OR, 3.39; 95% CI, 2.21-5.21). CONCLUSIONS:Strokepatients with development of delirium have unfavorable outcomes, particularly higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Early recognition and prevention of delirium may improve outcomes in strokepatients.
Authors: Alexandra J Lansky; Steven R Messé; Adam M Brickman; Michael Dwyer; H Bart van der Worp; Ronald M Lazar; Cody G Pietras; Kevin J Abrams; Eugene McFadden; Nils H Petersen; Jeffrey Browndyke; Bernard Prendergast; Vivian G Ng; Donald E Cutlip; Samir Kapadia; Mitchell W Krucoff; Axel Linke; Claudia Scala Moy; Joachim Schofer; Gerrit-Anne van Es; Renu Virmani; Jeffrey Popma; Michael K Parides; Susheel Kodali; Michel Bilello; Robert Zivadinov; Joseph Akar; Karen L Furie; Daryl Gress; Szilard Voros; Jeffrey Moses; David Greer; John K Forrest; David Holmes; Arie P Kappetein; Michael Mack; Andreas Baumbach Journal: Eur Heart J Date: 2018-05-14 Impact factor: 29.983
Authors: Michael E Reznik; J Michael Schmidt; Ali Mahta; Sachin Agarwal; David J Roh; Soojin Park; Hans Peter Frey; Jan Claassen Journal: Neurocrit Care Date: 2017-06 Impact factor: 3.210
Authors: Carl Moritz Zipser; Jeremy Deuel; Jutta Ernst; Maria Schubert; Michael Weller; Roland von Känel; Soenke Boettger Journal: J Neurol Date: 2019-09-13 Impact factor: 4.849