Open AccessPrevalence for delirium in stroke patients: A prospective controlled study
Author(s) -
Nydahl Peter,
Bartoszek Gabriele,
Binder Andreas,
Paschen Laura,
Margraf Nils G.,
Witt Karsten,
Ewers Andre
Publication year - 2017
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.748
Subject(s) - delirium , medicine , stroke (engine) , interquartile range , observational study , prospective cohort study , dementia , rehabilitation , pediatrics , organic mental disorders , physical therapy , intensive care medicine , disease , mechanical engineering , engineering
Background and Purpose This study investigates the prevalence of delirium in acute stroke patients on a primary stroke unit ( SU ) analyzing associated risk factors and clinical outcomes. Method Prospective, 4‐month observational study from 2015 to 2016 on patients aged ≥18 years with stroke at a German university hospital's SU . The presence of delirium as first outcome was rated at three times daily using the Confusion Assessment Method ( CAM ). Secondary outcome measures were duration of delirium, rehabilitation in SU , length of stay in SU and hospital, complications, and mortality. Significant risk factors were used to conduct a confounder‐matched case–control analysis. Results 309 patients were included. The overall prevalence of delirium was 10.7% (33 patients) mostly on the first and second hospital day. Duration of delirium on SU was in median 1.0 day (Interquartile range: 0.3–2 days). In 39.4% of patients delirium was present in a short time interval (≤8 hr) and in 24% of patients delirium was diagnosed during nightshifts exclusively. Significant risk factors for delirium were dementia, age ≥72 years, severe neurological disability on admission, and increased C‐reactive protein on admission. The case–control analysis showed that delirious patients had more complications and a trend toward a worse rehabilitation. Conclusions These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies are needed to find delirium prevention strategies.