Publication details

Towards a predictive model for post-stroke delirium

Authors

KOŠŤÁLOVÁ Milena BEDNAŘÍK Josef MITÁŠOVÁ Adéla DUŠEK Ladislav MICHALČÁKOVÁ Radka KEŘKOVSKÝ Miloš KAŠPÁREK Tomáš JEŽKOVÁ Martina BALABÁNOVÁ Petra VOHÁŇKA Stanislav

Year of publication 2012
Type Article in Periodical
Magazine / Source Brain Injury
MU Faculty or unit

Central European Institute of Technology

Citation
Doi http://dx.doi.org/10.3109/02699052.2012.660510
Field Neurology, neurosurgery, neurosciences
Keywords Delirium; stroke; risk factors; incidence; prediction
Description Primary objective: To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium. Research design: 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.
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