Dataset Information

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS).

ABSTRACT:

Background and purpose

Delirium is a very common neurobehavioral complication after stroke, but its influence on long-term outcome is not well characterized. The objective of the study was to determine the prognostic significance of delirium for functional status, nursing home admission, and mortality in a large cohort of patients with delirium in the acute phase of stroke assessed 3 and 12 months after stroke.

Methods

All stroke survivors included in PROPOLIS were followed up (n?=?682). Outcome data included: discharge destination, recurrence of stroke, cardiovascular complications, functional activity and mobility, nursing home admission, and mortality.

Results

Patients with delirium were discharged to another hospital or nursing home significantly more often than those presenting without delirium. The 3- and 12-month post-stroke mortality rates were higher in delirious patients (OR 6.41 CI 3.76-10.92; p?ConclusionsDelirium in acute phase of stroke negatively influences the long-term prognosis. A study addressing the effect of early recognition and treatment of identified modifiable risk factors for adverse long-term outcomes is urgently needed to decrease bad prognosis within this population.

SUBMITTER: Pasinska P

PROVIDER: S-EPMC6803586 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS).

Pasińska Paulina P Wilk Aleksander A Kowalska Katarzyna K Szyper-Maciejowska Aleksandra A Klimkowicz-Mrowiec Aleksandra A

Journal of neurology 20190719 11

<h4>Background and purpose</h4>Delirium is a very common neurobehavioral complication after stroke, but its influence on long-term outcome is not well characterized. The objective of the study was to determine the prognostic significance of delirium for functional status, nursing home admission, and mortality in a large cohort of patients with delirium in the acute phase of stroke assessed 3 and 12 months after stroke.<h4>Methods</h4>All stroke survivors included in PROPOLIS were followed up (n ...[more]

PMID: 31325015

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Project description:BackgroundPost-stroke delirium (PSD) is a modifiable predictor for worse outcome in stroke. Knowledge of its risk factors would facilitate clinical management of affected patients, but recently updated national guidelines consider available evidence insufficient.AimsThe study aimed to establish risk factors for PSD incidence and duration using high-frequency screening.MethodsWe prospectively investigated patients with ischemic stroke admitted within 24 h. Patients were screened twice daily for the presence of PSD throughout the treatment period. Sociodemographic, treatment-related, and neuroimaging characteristics were evaluated as predictors of either PSD incidence (odds ratios (OR)) or duration (PSD days/unit of the predictor, b), using logistic and linear regression models, respectively.ResultsPSD occurred in 55/141 patients (age = 73.8 ± 10.4 years, 61 female, National Institutes of Health Stroke Scale (NIHSS) = 6.4 ± 6.5). Age (odds ratio (OR) = 1.06 (95% confidence interval (CI): 1.02-1.10), b = 0.08 (95% CI = 0.04-0.13)), and male gender (b = 0.99 (95% CI = 0.05-1.93)) were significant non-modifiable risk factors. In a multivariable model adjusted for age and gender, presence of pain (OR < sub > mvar </sub >= 1.75 (95% CI = 1.12-2.74)), urinary catheter (OR < sub > mvar </sub > = 3.16 (95% CI = 1.10-9.14)) and post-stroke infection (PSI; OR < sub > mvar </sub > = 4.43 (95% CI = 1.09-18.01)) were predictors of PSD incidence. PSD duration was impacted by presence of pain (b < sub > mvar </sub >= 0.49 (95% CI = 0.19-0.81)), urinary catheter (b < sub > mvar </sub > = 1.03 (95% CI = 0.01-2.07)), intravenous line (b < sub > mvar </sub >= 0.36 (95% CI = 0.16-0.57)), and PSI (b < sub > mvar </sub >= 1.60 (95% CI = 0.42-2.78)). PSD (OR = 3.53 (95% CI = 1.48-5.57)) and PSI (OR = 5.29 (95% CI = 2.92-7.66)) independently predicted inferior NIHSS at discharge. Insular and basal ganglia lesions increased the PSD risk about four- to eight-fold.Discussion/conclusionThis study identified modifiable risk factors, the management of which might reduce the negative impact PSD has on outcome.

Dataset Information

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS).

Background and purpose

Methods

Results

Publications

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS).

Similar Datasets

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