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Delirium within three days of stroke in a cohort of elderly patients.
J Am Geriatr Soc 2006; 54(8):1192-8JA

Abstract

OBJECTIVES

To evaluate the incidence of stroke, risk factors for stroke, and outcomes in elderly stroke patients with delirium.

DESIGN

Cohort study with 12-month follow-up.

SETTING

Bankstown-Lidcombe Hospital, a 450-bed teaching hospital of the University of New South Wales, Sydney, Australia.

PARTICIPANTS

One hundred fifty-six stroke patients aged 65 and older recruited over 1 year.

MEASUREMENTS

Incidence of delirium (defined in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria) within 3 days poststroke, length of hospital stay, discharge destination, short- and long-term mortality, Functional Independence Measure (FIM) scores, and Mini-Mental State Examination (MMSE) scores.

RESULTS

Thirty-nine (25%) elderly stroke patients had delirium within 3 days after stroke. Logistic regression analysis found that older age (P=.04), hemorrhagic stroke (P=.02), metabolic disorders (P=.003), dementia prestroke (P=.02), Glasgow Coma Scale (GCS) score less than 15 on admission (P<.001), and inability to lift both arms on admission (P=.03) were independent predisposing factors for delirium. Patients who had a cardioembolic stroke (odds ratio (OR)=5.58) or total anterior circulation infarction (OR=3.42) were also more likely to develop delirium. Patients with delirium were associated with higher 6- and 12-month mortality (P<.05), lower 12-month FIM and MMSE scores, and a higher 12-month institutionalization rate.

CONCLUSION

Delirium occurred frequently in acute stroke patients aged 65 and older. Factors independently associated with delirium included old age, intracerebral hemorrhage, metabolic factors, prestroke dementia, initial GCS less than 15, and inability to lift both arms on admission. Patients with delirium had higher long-term mortality and a worse functional outcome.

Authors+Show Affiliations

Department of Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, Sydney, Australia. shengaizhen@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16913984

Citation

Sheng, Ai Zhen, et al. "Delirium Within Three Days of Stroke in a Cohort of Elderly Patients." Journal of the American Geriatrics Society, vol. 54, no. 8, 2006, pp. 1192-8.
Sheng AZ, Shen Q, Cordato D, et al. Delirium within three days of stroke in a cohort of elderly patients. J Am Geriatr Soc. 2006;54(8):1192-8.
Sheng, A. Z., Shen, Q., Cordato, D., Zhang, Y. Y., & Yin Chan, D. K. (2006). Delirium within three days of stroke in a cohort of elderly patients. Journal of the American Geriatrics Society, 54(8), pp. 1192-8.
Sheng AZ, et al. Delirium Within Three Days of Stroke in a Cohort of Elderly Patients. J Am Geriatr Soc. 2006;54(8):1192-8. PubMed PMID: 16913984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delirium within three days of stroke in a cohort of elderly patients. AU - Sheng,Ai Zhen, AU - Shen,Qing, AU - Cordato,Dennis, AU - Zhang,Yun Yun, AU - Yin Chan,Daniel Kam, PY - 2006/8/18/pubmed PY - 2006/9/20/medline PY - 2006/8/18/entrez SP - 1192 EP - 8 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 54 IS - 8 N2 - OBJECTIVES: To evaluate the incidence of stroke, risk factors for stroke, and outcomes in elderly stroke patients with delirium. DESIGN: Cohort study with 12-month follow-up. SETTING: Bankstown-Lidcombe Hospital, a 450-bed teaching hospital of the University of New South Wales, Sydney, Australia. PARTICIPANTS: One hundred fifty-six stroke patients aged 65 and older recruited over 1 year. MEASUREMENTS: Incidence of delirium (defined in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria) within 3 days poststroke, length of hospital stay, discharge destination, short- and long-term mortality, Functional Independence Measure (FIM) scores, and Mini-Mental State Examination (MMSE) scores. RESULTS: Thirty-nine (25%) elderly stroke patients had delirium within 3 days after stroke. Logistic regression analysis found that older age (P=.04), hemorrhagic stroke (P=.02), metabolic disorders (P=.003), dementia prestroke (P=.02), Glasgow Coma Scale (GCS) score less than 15 on admission (P<.001), and inability to lift both arms on admission (P=.03) were independent predisposing factors for delirium. Patients who had a cardioembolic stroke (odds ratio (OR)=5.58) or total anterior circulation infarction (OR=3.42) were also more likely to develop delirium. Patients with delirium were associated with higher 6- and 12-month mortality (P<.05), lower 12-month FIM and MMSE scores, and a higher 12-month institutionalization rate. CONCLUSION: Delirium occurred frequently in acute stroke patients aged 65 and older. Factors independently associated with delirium included old age, intracerebral hemorrhage, metabolic factors, prestroke dementia, initial GCS less than 15, and inability to lift both arms on admission. Patients with delirium had higher long-term mortality and a worse functional outcome. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16913984/Delirium_within_three_days_of_stroke_in_a_cohort_of_elderly_patients_ L2 - https://doi.org/10.1111/j.1532-5415.2006.00806.x DB - PRIME DP - Unbound Medicine ER -