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P4‐136: Cigarette Smoking is An Independent Risk Factor for Post‐Stroke Delirium
Author(s) -
Lim Tae Sung
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.2227
Subject(s) - delirium , medicine , stroke (engine) , modified rankin scale , risk factor , anesthesia , intensive care medicine , ischemic stroke , mechanical engineering , ischemia , engineering
Background: Post-stroke delirium is a common problem in care of stroke patients and is known to be associated with longer hospitalization, high short term mortality and increased need for long-term care. It usually occurs in about 10w30% of patients but only a little has been studied about the risk factors of post-stroke delirium in acute stroke care unit. Methods: A total of 576 consecutive patients with stroke (mean age, 65.2 years; range, 23–93 years) were screened for delirium from 2012/8/1 through 2014/7/31 in acute stroke care unit of a tertiary referral hospital.We screened deliriumwith the Confusion Assessment Method (CAM). Once delirium was suspected, we evaluated the symptoms with Korean Version of the Delirium Rating ScaleRevised-98 (K-DRS-R-98). Neurologic deficits were assessedwith the NIH Stroke Scale at admission and discharge and functional ability with the Barthel Index (BI) and modified Rankin Scale (mRS) at discharge and 3 months after discharge. Results:Thirty-eight patients with stroke (6.7%) developed delirium during admission in acute stroke care unit. Patients with delirium were significantly older (70.6 vs 64.9, p1⁄40.001) and smoking cigarette more frequently (40% vs 24%, p1⁄40.033) than without delirium. In terms of clinical features, delirium group had significantly higher rate of major hemispheric stroke (55% vs 26%, p<0.001) and showed poor functional performance at discharge and 3 months after discharge and significantly longer hospitalization period. Independent risk factors for delirium were older age, cigarette smoking and major hemispheric stroke. Conclusions:Cessation of current cigarette smoking during admission was associated with post-stroke delirium. The occurrence of delirium after stroke is associated with longer hospitalization period and worse outcomes and should be monitored and managed carefully.