Towards a predictive model for post-stroke delirium.
Brain Inj
; 26(7-8): 962-71, 2012.
Article
in En
| MEDLINE
| ID: mdl-22571183
ABSTRACT
PRIMARY OBJECTIVE:
To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium. RESEARCHDESIGN:
A prospective observational study in a cohort of consecutive patients with ischemic stroke or intracerebral haematoma admitted within 24 hours of stroke onset.METHODS:
Patients were assessed daily for delirium during the first week by means of DSM-IV criteria and risk factors were recorded.RESULTS:
One hundred patients completed a 7-day evaluation (47 women and 53 men, median age 77 years). An episode of delirium was detected in 43 patients (43%). Using multivariate logistic regression, a predictive statistical model was developed that utilized independent risk factors age (OR = 1.08; 95% CI = 1.02-1.15); intracerebral haemorrhage (OR = 6.11; 95% CI = 1.62-22.98), lesion volume > 40 ccm (OR = 3.99; 95% CI = 1.29-12.39) and either elevated gamma-glytamyl transferase (OR = 4.88; 95% CI = 1.45-16.35) and elevated serum bilirubin (OR = 3.70; 95% CI = 1.32-10.38) or maximum sequential organ failure assessment score >2 (OR = 3.33; 95% CI = 1.06-10.45) with acceptable sensitivity and specificity (69.0% and 80.7%). In ischemic strokes, total anterior circulation infarctions were more frequently associated with delirium (73.3% developed delirium) compared with the remainder of the groups combined (p = 0.004; OR = 6.66; 95% CI = 1.85-24.01).CONCLUSION:
Higher age, metabolic disturbances, intracerebral haemorrhage and larger ischemic hemispheric strokes increase the risk of post-stroke delirium.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bilirubin
/
C-Reactive Protein
/
Cerebral Hemorrhage
/
Stroke
/
Delirium
/
Gamma-Glutamyltransferase
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Brain Inj
Journal subject:
CEREBRO
Year:
2012
Document type:
Article
Affiliation country:
Czech Republic