Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening

 Why in hell are you doing the useless research on predicting delirium rather than actually preventing delirium? Do you have two neurons to rub together?

Since we've known for years that 1 in 4 have delirium post stroke why are your mentors and senior researchers so incompetent they let you do prediction research rather than solution research?

• 1 in 4 have delirium post stroke (2 posts to July 2020)

Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening

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Robert Fleischmann*, Tina Andrasch*, Sina Warwas, ...

First Published July 21, 2022 Research Article Find in PubMed 

https://doi.org/10.1177/17474930221109353

Article information

Abstract

Background:

Post-stroke delirium (PSD) is a modifiable predictor for worse outcome in stroke. Knowledge of its risk factors would facilitate clinical management of affected patients, but recently updated national guidelines consider available evidence insufficient.

Aims:

The study aimed to establish risk factors for PSD incidence and duration using high-frequency screening.

Methods:

We prospectively investigated patients with ischemic stroke admitted within 24 h. Patients were screened twice daily for the presence of PSD throughout the treatment period. Sociodemographic, treatment-related, and neuroimaging characteristics were evaluated as predictors of either PSD incidence (odds ratios (OR)) or duration (PSD days/unit of the predictor, b), using logistic and linear regression models, respectively.

Results:

PSD occurred in 55/141 patients (age = 73.8 ± 10.4 years, 61 female, National Institutes of Health Stroke Scale (NIHSS) = 6.4 ± 6.5). Age (odds ratio (OR) = 1.06 (95% confidence interval (CI): 1.02–1.10), b = 0.08 (95% CI = 0.04–0.13)), and male gender (b = 0.99 (95% CI = 0.05–1.93)) were significant non-modifiable risk factors. In a multivariable model adjusted for age and gender, presence of pain (OR < sub > mvar </sub >= 1.75 (95% CI = 1.12–2.74)), urinary catheter (OR < sub > mvar </sub > = 3.16 (95% CI = 1.10–9.14)) and post-stroke infection (PSI; OR < sub > mvar </sub > = 4.43 (95% CI = 1.09–18.01)) were predictors of PSD incidence. PSD duration was impacted by presence of pain (b < sub > mvar </sub >= 0.49 (95% CI = 0.19–0.81)), urinary catheter (b < sub > mvar </sub > = 1.03 (95% CI = 0.01–2.07)), intravenous line (b < sub > mvar </sub >= 0.36 (95% CI = 0.16–0.57)), and PSI (b < sub > mvar </sub >= 1.60 (95% CI = 0.42–2.78)). PSD (OR = 3.53 (95% CI = 1.48–5.57)) and PSI (OR = 5.29 (95% CI = 2.92–7.66)) independently predicted inferior NIHSS at discharge. Insular and basal ganglia lesions increased the PSD risk about four- to eight-fold.

Discussion/Conclusion:

This study identified modifiable risk factors, the management of which might reduce the negative impact PSD has on outcome.