Predictors of delirium in poststroke patients

Delirium is a common disorder in patients after stroke. We designed a study to evaluate the incidence of delirium and risk factors for its occurrence after stroke. Design and setting: Prospective cohort study at Hospital Geral Roberto Santos. Methods: Patients were admitted within 72h of ictus. Delirium was assessed using the Confusion Assessment Method in an Intensive Care Unit scale. Results: 279 patients were enrolled, with a mean age of 61.08 (± 13.05) years, 54.0% of whom were men. The incidence of delirium was 28% (n = 78). Delirium patients were older (68.9 ± 12.6 vs 58.8 ± 12.5; p <0.001) and had a higher NIHSS on admission [11 (7-15) vs 8 (5-12); p <0.001]. The occurrence of delirium was associated with a previous diagnosis of hypertension [RR = 2.62 (1.13-6.09)], hemorrhagic stroke [RR 1.94 (1.13-2.86)], cardioembolic etiology [RR 2.21 (1.22-3.97)] and infection during hospitalization [RR 5.27 (3.54-7.84)]. Independent predictors of delirium: age ≥ 65 years [OR 1.06 (1.02 -1.10)], epileptic seizures in ictus [OR 6.28 (1.65 - 23.91)], infection [OR 14.17 (6.39 - 31.43)] and hemorrhagic stroke [OR 4.04 (1.51-10.78)]. Conclusion: Delirium is a common complication after acute stroke, affecting 28% of patients. In view of the importance of identifying risk factors in the acute setting of stroke, further studies are needed to elucidate the association of the findings with the occurrence of delirium.