Dataset Information

Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening.

ABSTRACT:

Background

Post-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.

Aims

The study aimed to establish risk factors for PSD incidence and duration using high-frequency screening.

Methods

We 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.

Results

PSD 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 = 1.75 (95% CI = 1.12-2.74)), urinary catheter (OR < sub > mvar = 3.16 (95% CI = 1.10-9.14)) and post-stroke infection (PSI; OR < sub > mvar = 4.43 (95% CI = 1.09-18.01)) were predictors of PSD incidence. PSD duration was impacted by presence of pain (b < sub > mvar = 0.49 (95% CI = 0.19-0.81)), urinary catheter (b < sub > mvar = 1.03 (95% CI = 0.01-2.07)), intravenous line (b < sub > mvar = 0.36 (95% CI = 0.16-0.57)), and PSI (b < sub > mvar = 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/conclusion

This study identified modifiable risk factors, the management of which might reduce the negative impact PSD has on outcome.

SUBMITTER: Fleischmann R

PROVIDER: S-EPMC9940154 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening.

Fleischmann Robert R Andrasch Tina T Warwas Sina S Kunz Rhina R Gross Stefan S Witt Carl C Ruhnau Johanna J Vogelgesang Antje A Ulm Lena L Mengel Annerose A von Sarnowski Bettina B

International journal of stroke : official journal of the International Stroke Society 20220721 3

<h4>Background</h4>Post-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.<h4>Aims</h4>The study aimed to establish risk factors for PSD incidence and duration using high-frequency screening.<h4>Methods</h4>We prospectively investigated patients with ischemic stroke admitted within 24 h. Patients were ...[more]

PMID: 35722813

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Dataset Information

Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening.

Background

Aims

Methods

Results

Discussion/conclusion

Publications

Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening.

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