Antonio Callea (Italy)
Università Cattolica del Sacro Cuore NeurosciencesAuthor Of 1 Presentation
DELIRIUM IN ACUTE STROKE: A SINGLE CENTRE, PROSPECTIVE, CROSS-SECTIONAL, COHORT STUDY
- Eleonora Rollo (Italy)
Abstract
Background and Aims:
Delirium is an acute fluctuating disorder of attention and awareness. The endpoints of our study were: 1) incidence of delirium in acute stroke; 2) risk factors for delirium; 3) impact of delirium on the outcome of stroke.
Methods:
Patients were consecutively enrolled in a stroke unit from April to October 2020. Inclusion criteria were: age ≥18 years, acute stroke and NIHSS≥1. Exclusion criteria were: negative neuroimaging, stroke mimics, and need for ICU treatment. All patients were evaluated by means of Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method-Intensive Care Unit (CAM-ICU) scores at baseline, within 72 hours or when patients developed symptoms suggesting delirium. The outcome was assessed by means of modified Rankin Scale at 90 days.
Results:
The overall incidence of delirium was 36/120 (30%). Delirium was associated with aphasia (OR 9.77; CI 1.2-79.6), chronic obstructive pulmonary disease (COPD) (OR 16.67; CI 1.1-263.0), deep Fazekas score (OR 5.05; CI 1.7-14.8), and physical restraint (OR 45.02; CI 1.4-1411.5). At 3 months follow-up evaluation, patients with delirium had more disability (DLR+: mRS=4; DLR–: mRS=1; Beta=1.43; CI 0.61-2.24; p=0.001) and shorter survival (DLR+: 84±20 days; DLR–: 87±13 days; p=0.048).
Conclusions:
Nearly one-third of patients (30%) had delirium in the acute phase of stroke. This finding supports the notion that delirium is a common complication of stroke. Delirium was associated with speech disorder, leukoencephalopathy, COPD and early use of physical restraint. Delirium was associated with increased risk of disability and shorter survival after stroke.