Ryuichiro Hosoya1, Yohei Sato2, Emika Ishida3, Haruna Shibamoto4, Seiichi Hino5, Hiroaki Yokote6, Tomoyuki Kamata7. 1. Department of Pharmacy, Japanese Red Cross Musashino Hospital, Musashino, Tokyo, Japan; Department of Clinical Pharmaceutics, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan. 2. Department of Neurosurgery, Japanese Red Cross Musashino Hospital, Musashino, Tokyo, Japan. Electronic address: satonsrg@musashino.jrc.or.jp. 3. Department of Nurse, Japanese Red Cross Musashino Hospital, Musashino, Tokyo, Japan. 4. Department of Nursing, Faculty of Nursing, Mejiro University Medical Staff Training Center, Wako, Saitama, Japan. 5. Department of Pharmacy, Japanese Red Cross Musashino Hospital, Musashino, Tokyo, Japan. 6. Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano, Tokyo, Japan. 7. Department of Neurology, Japanese Red Cross Musashino Hospital, Musashino, Tokyo, Japan.
Abstract
PURPOSE: Medication is an important risk factor for delirium; however, the association between delirium and prehospitalization medication is unclear. We investigated the association between prestroke medication and poststroke delirium. MATERIALS AND METHODS: All patients hospitalized in the stroke care unit from September 2011 to September 2012 were selected, and their delirium symptoms, patient information, and pre- and poststroke medications were analyzed. Delirium was defined as a score of 4 or higher on the Intensive Care Delirium Screening Checklist. Factors that were related to delirium were extracted using univariate analysis, and the independent risk factors were determined using multivariate analysis. RESULTS: Of the 269 patients analyzed, 97 (36%) experienced delirium. Univariate analysis revealed significant differences between the delirium and nondelirium groups in age, dementia, previous cerebrovascular disease, craniotomy, all insertion-tube types, and 6 categories of prestroke medication. Prestroke polypharmacy was associated with poststroke delirium (P = .002). Multivariate analysis showed that taking antianxiety agents or sleep aids was an independent risk factor for delirium (odds ratio: 3.17, 95% confidence interval: 1.16-8.82). CONCLUSIONS: The present study suggests that prestroke medication affects the onset of poststroke delirium. These findings can contribute to the prediction and prevention of this condition.
PURPOSE: Medication is an important risk factor for delirium; however, the association between delirium and prehospitalization medication is unclear. We investigated the association between prestroke medication and poststroke delirium. MATERIALS AND METHODS: All patients hospitalized in the stroke care unit from September 2011 to September 2012 were selected, and their delirium symptoms, patient information, and pre- and poststroke medications were analyzed. Delirium was defined as a score of 4 or higher on the Intensive Care Delirium Screening Checklist. Factors that were related to delirium were extracted using univariate analysis, and the independent risk factors were determined using multivariate analysis. RESULTS: Of the 269 patients analyzed, 97 (36%) experienced delirium. Univariate analysis revealed significant differences between the delirium and nondelirium groups in age, dementia, previous cerebrovascular disease, craniotomy, all insertion-tube types, and 6 categories of prestroke medication. Prestroke polypharmacy was associated with poststroke delirium (P = .002). Multivariate analysis showed that taking antianxiety agents or sleep aids was an independent risk factor for delirium (odds ratio: 3.17, 95% confidence interval: 1.16-8.82). CONCLUSIONS: The present study suggests that prestroke medication affects the onset of poststroke delirium. These findings can contribute to the prediction and prevention of this condition.
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