PRIMARY OBJECTIVE: To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium. RESEARCH DESIGN: A prospective observational study in a cohort of consecutive patients with ischemic stroke or intracerebral haematoma admitted within 24 hours of stroke onset. METHODS: Patients were assessed daily for delirium during the first week by means of DSM-IV criteria and risk factors were recorded. RESULTS: One hundred patients completed a 7-day evaluation (47 women and 53 men, median age 77 years). An episode of delirium was detected in 43 patients (43%). Using multivariate logistic regression, a predictive statistical model was developed that utilized independent risk factors: age (OR = 1.08; 95% CI = 1.02-1.15); intracerebral haemorrhage (OR = 6.11; 95% CI = 1.62-22.98), lesion volume > 40 ccm (OR = 3.99; 95% CI = 1.29-12.39) and either elevated gamma-glytamyl transferase (OR = 4.88; 95% CI = 1.45-16.35) and elevated serum bilirubin (OR = 3.70; 95% CI = 1.32-10.38) or maximum sequential organ failure assessment score >2 (OR = 3.33; 95% CI = 1.06-10.45) with acceptable sensitivity and specificity (69.0% and 80.7%). In ischemic strokes, total anterior circulation infarctions were more frequently associated with delirium (73.3% developed delirium) compared with the remainder of the groups combined (p = 0.004; OR = 6.66; 95% CI = 1.85-24.01). CONCLUSION: Higher age, metabolic disturbances, intracerebral haemorrhage and larger ischemic hemispheric strokes increase the risk of post-stroke delirium.
PRIMARY OBJECTIVE: To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium. RESEARCH DESIGN: A prospective observational study in a cohort of consecutive patients with ischemic stroke or intracerebral haematoma admitted within 24 hours of stroke onset. METHODS:Patients were assessed daily for delirium during the first week by means of DSM-IV criteria and risk factors were recorded. RESULTS: One hundred patients completed a 7-day evaluation (47 women and 53 men, median age 77 years). An episode of delirium was detected in 43 patients (43%). Using multivariate logistic regression, a predictive statistical model was developed that utilized independent risk factors: age (OR = 1.08; 95% CI = 1.02-1.15); intracerebral haemorrhage (OR = 6.11; 95% CI = 1.62-22.98), lesion volume > 40 ccm (OR = 3.99; 95% CI = 1.29-12.39) and either elevated gamma-glytamyl transferase (OR = 4.88; 95% CI = 1.45-16.35) and elevated serum bilirubin (OR = 3.70; 95% CI = 1.32-10.38) or maximum sequential organ failure assessment score >2 (OR = 3.33; 95% CI = 1.06-10.45) with acceptable sensitivity and specificity (69.0% and 80.7%). In ischemic strokes, total anterior circulation infarctions were more frequently associated with delirium (73.3% developed delirium) compared with the remainder of the groups combined (p = 0.004; OR = 6.66; 95% CI = 1.85-24.01). CONCLUSION: Higher age, metabolic disturbances, intracerebral haemorrhage and larger ischemic hemispheric strokes increase the risk of post-stroke delirium.
Authors: Terence J Quinn; Edo Richard; Yvonne Teuschl; Thomas Gattringer; Melanie Hafdi; John T O'Brien; Niamh Merriman; Celine Gillebert; Hanne Huyglier; Ana Verdelho; Reinhold Schmidt; Emma Ghaziani; Hysse Forchammer; Sarah T Pendlebury; Rose Bruffaerts; Milija Mijajlovic; Bogna A Drozdowska; Emily Ball; Hugh S Markus Journal: Eur Stroke J Date: 2021-10-08
Authors: Mayur B Patel; Josef Bednarik; Patricia Lee; Yahya Shehabi; Jorge I Salluh; Arjen J Slooter; Kate E Klein; Yoanna Skrobik; Alessandro Morandi; Peter E Spronk; Andrew M Naidech; Brenda T Pun; Fernando A Bozza; Annachiara Marra; Sayona John; Pratik P Pandharipande; E Wesley Ely Journal: Crit Care Med Date: 2018-11 Impact factor: 7.598
Authors: Mooyeon Oh-Park; Peii Chen; Vickie Romel-Nichols; Kimberly Hreha; Olga Boukrina; A M Barrett Journal: Am J Phys Med Rehabil Date: 2018-10 Impact factor: 2.159
Authors: John Y Rhee; Mia A Colman; Maanasa Mendu; Simran J Shah; Michael D Fox; Natalia S Rost; Eyal Y Kimchi Journal: J Stroke Cerebrovasc Dis Date: 2021-12-23 Impact factor: 2.136
Authors: Vasileios Siokas; Robert Fleischmann; Katharina Feil; Ioannis Liampas; Markus C Kowarik; Yang Bai; Maria-Ioanna Stefanou; Sven Poli; Ulf Ziemann; Efthimios Dardiotis; Annerose Mengel Journal: J Clin Med Date: 2022-10-01 Impact factor: 4.964