PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS): methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools

Klimiec, Elzbieta; Dziedzic, Tomasz; Kowalska, Katarzyna; Szyper, Aleksandra; Pera, Joanna; Potoczek, Paulina; Słowik, Agnieszka; Klimkowicz‐Mrowiec, Aleksandra

doi:10.1186/s12883-015-0351-z

Cited by 29 publications

(26 citation statements)

References 56 publications

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“…Second, anticholinergic medication(s) was not recorded, and the use of this medication could be associated with delirium [17]. Furthermore, a prospective studies involving a structured questionnaire to assess pre-stroke cognition and medication use, and treatment trials involving cholinesterase inhibitors [21, 22] are warranted.…”

Section: Discussionmentioning

confidence: 99%

Cigarette smoking is an independent risk factor for post-stroke delirium

et al. 2017

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BackgroundPost-stroke delirium is a common problem in the care of stroke patients, and is associated with longer hospitalization, high short-term mortality, and an increased need for long-term care. Although post-stroke delirium occurs in approximately 10 ~ 30% of patients, little is known about the risk factors for post-stroke delirium in patients who experience acute stroke.MethodsA total of 576 consecutive patients who experienced ischemic stroke (mean age, 65.2 years; range, 23–93 years) were screened for delirium over a 2-year period in an acute stroke care unit of a tertiary referral hospital. We screened for delirium using the Confusion Assessment Method. Once delirium was suspected, we evaluated the symptoms using the Korean Version of the Delirium Rating Scale-Revised-98. Neurological deficits were assessed using the National Institutes of Health Stroke Scale at admission and discharge, and functional ability was assessed using the Barthel Index and modified Rankin Scale at discharge and 3 months after discharge.ResultsThirty-eight (6.7%) patients with stroke developed delirium during admission to the acute stroke care unit. Patients with delirium were significantly older (70.6 vs. 64.9 years of age, P = .001) and smoked cigarettes more frequently (40% vs. 24%, P = .033) than patients without delirium. In terms of clinical features, the delirium group experienced a significantly higher rate of major hemispheric stroke (55% vs. 26%, P < .001), exhibited poorer functional performance at discharge and 3 months after discharge, and stayed in hospital significantly longer. Independent risk factors for delirium were older age, history of cigarette smoking, and major hemispheric stroke.ConclusionAbrupt cessation of cigarette smoking may be a risk factor for post-stroke delirium in ischemic stroke patients. The development of delirium after stroke is associated with worse outcome and longer hospitalization.

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Section: Discussionmentioning

confidence: 99%

Cigarette smoking is an independent risk factor for post-stroke delirium

et al. 2017

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“…The Prospective Observational Polish Study on Delirium (PROPOLIS) was conducted between May 2014 and March 2016 in the Department of Neurology, University Hospital, Krakow, Poland. The study protocol was approved by the Bioethics Committee of the Jagiellonian University and is published elsewhere .…”

Section: Methodsmentioning

confidence: 99%

Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke

Klimiec-Moskal

Lis

Pera

et al. 2019

Euro J of Neurology

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Background and purpose Subsyndromal delirium (SSD) refers to patients with delirious symptoms who do not meet the criteria for delirium. The aim was to determine the prognostic significance of SSD in stroke patients. Methods In all, 564 patients with ischaemic stroke (median age 71 years, 50.5% female) were included. The Confusion Assessment Method was used to assess symptoms of delirium and the Diagnostic and Statistical Manual of Mental Disorders, 5th edn, criteria were used to diagnose delirium. SSD was defined as one or more core features of delirium without fulfilling diagnostic criteria. Functional outcome was assessed using the modified Rankin Scale at 3 and 12 months after stroke. Results Delirium was diagnosed in 23.4% of patients and SSD in 10.3% of patients. SSD was associated with increased risk of poor functional outcome. The adjusted odds ratios (ORs) for unfavourable outcome at 3 and 12 months were 2.88 [95% confidence interval (CI) 1.43–5.79, P < 0.01] and 2.93 (95% CI 1.39–6.22, P < 0.01), respectively. In multivariate analysis, delirium was an independent predictor of poor functional outcome at 3 months (OR 6.41, 95% CI 3.36–12.21, P < 0.01) and 12 months (OR 6.11, 95% CI 3.05–12.27, P < 0.01) after stroke. Delirium was also independently associated with increased risk of death within 3 months (hazard ratio 3.68, 95% CI 1.69–8.02, P < 0.01) and 12 months (hazard ratio 3.76, 95% CI 2.05–6.90, P < 0.01). SSD was not associated with increased risk of death. Conclusions In SSD patients the risk of poor functional outcome after stroke is increased and intermediate between patients with and patients without delirium.

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“…Second, anticholinergic medication(s) was not recorded, and the use of this medication could be associated with delirium [17]. Furthermore, a prospective studies involving a structured questionnaire to assess prestroke cognition and medication use, and treatment trials involving cholinesterase inhibitors [21,22] are warranted.…”

Section: Discussionmentioning

confidence: 99%

P4‐136: Cigarette Smoking is An Independent Risk Factor for Post‐Stroke Delirium

Lim

2016

Alzheimer's & Dementia

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Background: Post-stroke delirium is a common problem in the care of stroke patients, and is associated with longer hospitalization, high short-term mortality, and an increased need for long-term care. Although post-stroke delirium occurs in approximately 10~30% of patients, little is known about the risk factors for post-stroke delirium in patients who experience acute stroke. Methods: A total of 576 consecutive patients who experienced ischemic stroke (mean age, 65.2 years; range, 23-93 years) were screened for delirium over a 2-year period in an acute stroke care unit of a tertiary referral hospital. We screened for delirium using the Confusion Assessment Method. Once delirium was suspected, we evaluated the symptoms using the Korean Version of the Delirium Rating Scale-Revised-98. Neurological deficits were assessed using the National Institutes of Health Stroke Scale at admission and discharge, and functional ability was assessed using the Barthel Index and modified Rankin Scale at discharge and 3 months after discharge. Results: Thirty-eight (6.7%) patients with stroke developed delirium during admission to the acute stroke care unit. Patients with delirium were significantly older (70.6 vs. 64.9 years of age, P = .001) and smoked cigarettes more frequently (40% vs. 24%, P = .033) than patients without delirium. In terms of clinical features, the delirium group experienced a significantly higher rate of major hemispheric stroke (55% vs. 26%, P < .001), exhibited poorer functional performance at discharge and 3 months after discharge, and stayed in hospital significantly longer. Independent risk factors for delirium were older age, history of cigarette smoking, and major hemispheric stroke. Conclusion: Abrupt cessation of cigarette smoking may be a risk factor for post-stroke delirium in ischemic stroke patients. The development of delirium after stroke is associated with worse outcome and longer hospitalization.

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PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS): methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools

Cited by 29 publications

References 56 publications

Cigarette smoking is an independent risk factor for post-stroke delirium

Cigarette smoking is an independent risk factor for post-stroke delirium

Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke

P4‐136: Cigarette Smoking is An Independent Risk Factor for Post‐Stroke Delirium

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