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ABSTRACT: Objectives
To characterize the risk of long-term cognitive impairment associated with delirium in acute neurologic injury patients.Design
We analyzed a 10-year cohort of adult acute neurologic injury patients (stroke and traumatic brain injury) without preexisting mild cognitive impairment or dementia, utilizing administrative databases. Patients were followed for in-hospital delirium and mild cognitive impairment or dementia. We report incidence and adjusted hazard ratios for mild cognitive impairment or dementia associated with delirium. Subgroups analyzed include acute neurologic injury categories, dementia subtypes, repeated delirium exposure, and age strata.Setting
We used state emergency department and state inpatient databases for New York, Florida, and California. All visits are included in the databases regardless of payer status.Patients
We included adult patients with diagnosis of stroke and traumatic brain injury as acute neurologic injury. Patients with preexisting mild cognitive impairment or dementia were excluded.Interventions
None.Measurements and main results
Among 911,380 acute neurologic injury patients, 5.2% were diagnosed with delirium. Mild cognitive impairment or dementia incidence among delirium patients was approximately twice that of nondelirium patients. In adjusted models, risk of mild cognitive impairment or dementia was higher among patients with delirium (adjusted hazard ratio, 1.58). Increased risk was observed across all subgroups including patients less than or equal to 55 years old.Conclusions
Identification, management, and prevention of in-hospital delirium could potentially improve long-term cognitive outcomes in acute neurologic injury patients.
SUBMITTER: Meeks JR
PROVIDER: S-EPMC7314325 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Meeks Jennifer R JR Bambhroliya Arvind B AB Sheth Sunil A SA Khan Babar B Slooter Arjen J C AJC Ely E Wesley EW Miller Charles C CC Tyson Jon E JE McCullough Louise D LD Savitz Sean I SI Vahidy Farhaan S FS
Critical care explorations 20200609 6
<h4>Objectives</h4>To characterize the risk of long-term cognitive impairment associated with delirium in acute neurologic injury patients.<h4>Design</h4>We analyzed a 10-year cohort of adult acute neurologic injury patients (stroke and traumatic brain injury) without preexisting mild cognitive impairment or dementia, utilizing administrative databases. Patients were followed for in-hospital delirium and mild cognitive impairment or dementia. We report incidence and adjusted hazard ratios for mi ...[more]