Delirium in the acute phase after stroke
Incidence, risk factors, and outcome
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: This prospective cohort study assesses incidence of delirium after stroke. In addition, risk factors during the first week were assessed. Finally, outcome in relation to development of delirium was studied.
Methods: A total of 527 consecutive patients with stroke (median age, 72 years; range, 29–96 years) were screened for delirium during the first week after admission. We diagnosed delirium with the Confusion Assessment Method. Cognitive functioning prior to the stroke was assessed with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Neurologic deficits were assessed with the NIH Stroke Scale.
Results: A total of 62 patients with stroke (11.8%) developed delirium during the first week of admission. Independent risk factors were preexisting cognitive decline (odds ratio [OR] for IQCODE above 50: 2.6, 95% confidence interval [CI] 1.2–5.7) and infection (OR 3.4, 95% CI 1.7–6.8). Furthermore, right-sided hemispheric stroke (OR 2.0, 95% CI 1.0–3.0), anterior circulation large-vessel stroke (OR 3.4, 95% CI 1.1–10.2), the highest tertile of the NIH Stroke Scale (OR for highest vs lowest tertile 15.1, 95% CI 3.3–69.0), and brain atrophy (OR for highest versus lowest tertile 2.7, 95% CI 1.1–6.8) increased the risk for delirium. Delirium was associated with a worse outcome in terms of duration of hospitalization, mortality, and functional outcome.
Conclusions: Delirium occurs in almost 1 out of every 8 patients with stroke on a stroke unit and is associated with cognitive decline, infection, right-sided hemispheric stroke, anterior circulation large-vessel stroke, stroke severity, and brain atrophy. Delirium after stroke is associated with a worse outcome.
Footnotes
-
- ARWMC
- age-related white matter changes
- BI
- Barthel Index
- CAM
- Confusion Assessment Method
- CI
- confidence interval
- DRS
- Delirium Rating Scale
- IQCODE
- Informant Questionnaire on Cognitive Decline in the Elderly
- NIHSS
- NIH Stroke Scale
- OR
- odds ratio
- PACI
- partial anterior circulation infarction
- TACI
- total anterior circulation infarction
- Received July 27, 2010.
- Accepted November 23, 2010.
- Copyright © 2011 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Deborah Friedman and Dr. Stacy Smith
► Watch
Related Articles
- No related articles found.
Topics Discussed
Alert Me
Recommended articles
-
Article
Sex as a predictor of outcomes in patients treated with thrombolysis for acute strokeM.S.V. Elkind, S. Prabhakaran, J. Pittman et al.Neurology, March 12, 2007 -
Article
Early MoCA predicts long-term cognitive and functional outcome and mortality after strokeVera Zietemann, Marios K. Georgakis, Thibaut Dondaine et al.Neurology, October 17, 2018 -
Article
Thrombolytic therapy for stroke in patients with preexisting cognitive impairmentKei Murao, Didier Leys, Agnès Jacquin et al.Neurology, May 14, 2014 -
Article
Cerebral Small Vessel Disease MRI Features Do Not Improve the Prediction of Stroke OutcomeJuliette Coutureau, Julien Asselineau, Paul Perez et al.Neurology, November 12, 2020