Hilde Hénon (France)
CHU Lille LilNCog - Lille Neuroscience & CognitionAuthor Of 1 Presentation
EARLY-ONSET DELIRIUM AFTER SPONTANEOUS INTRACEREBRAL HEMORRHAGE
- Federico Marrama (Italy)
Abstract
Background and Aims:
This study aimed at identifying the incidence, predictors and impact on long-term mortality and new-onset dementia of early-onset delirium in a cohort of patients with spontaneous intracerebral hemorrhage (ICH).
Methods:
We prospectively recruited consecutive patients in the Prognosis of InTra-Cerebral Hemorrhage (PITCH) cohort and analyzed the incidence rate of early-onset delirium (i.e. during the first 7 days after ICH onset) with a competing risk model. We used a multivariable Fine-Gray model to identify baseline predictors, a Cox regression model to study its impact on the long-term risk of mortality and a Fine-Gray model adjusted for pre-specified confounders to analyze its impact on new-onset dementia.
Results:
The study population consisted of 248 patients (mean age 70 years, 54% males). Early-onset delirium incidence rate was 29.8% (95% confidence interval [CI] 24.3-35.6). Multivariable analysis showed that pre-existing dementia (subhazard ratio [SHR] 1.63, 95% CI 1.03-2.57, p=0.036) and heavy alcohol intake (SHR 2.43, 95% CI 1.49-3.95, p<0.001) were predictors of early-onset delirium. Median follow-up was 9.5 years (interquartile range 8.1-10). Early-onset delirium was associated with higher mortality rates during the first 5 years of follow-up (HR 1.54 95% CI 1.02-2.32, p=0.042), but not thereafter (HR 0.77, 95% CI 0.35-1.68). Early-onset delirium did not predict new-onset dementia (SHR 1.54 95% CI 0.81-2.92).
Conclusions:
Early-onset delirium is a frequent complication of ICH and it should be regarded as a marker of pre-existing brain vulnerability. After ICH, it is associated with a higher risk of mortality, but not of new-onset dementia on long-term follow-up.