From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland.
Stroke. 2019 Nov;50(11):3265-3268. doi: 10.1161/STROKEAHA.119.025993. Epub 2019 Sep 26.
Background and Purpose- Delirium is a common and serious complication of acute illness. We describe delirium occurrence in an unselected, acute stroke population. Methods- We collected data from consecutive stroke admissions. We performed comprehensive cognitive assessment within the first week including Diagnostic Statistical Manual-5-based delirium diagnosis. We reported proportion with delirium and the clinical and demographic associations with delirium using multiple logistic regression. Results- Of 708 patients, median age of 71 years (interquartile range, 59-80), we recorded delirium in 187 of 708 (26.4%; 95% CI, 23.0-30.0). Across 395 patients with complete risk factor data (105 delirium), factors independently associated with delirium were: age (odds ratio, 1.05; 95% CI, 1.03-1.08), drug/alcohol misuse (odds ratio, 2.64; 95% CI, 1.10-6.26), and stroke severity (odds ratio, 1.22; 95% CI, 1.14-1.31). Conclusions- Delirium is common in acute stroke, affecting 1 in 4. It may be possible to predict those at risk using prestroke and stroke-specific factors. Clinical Trial Registration- URL: researchregistry.com. Protocol: 1147.
背景与目的- 谵妄是急性疾病的常见且严重的并发症。我们描述了在未选择的急性脑卒中人群中谵妄的发生情况。方法- 我们连续收集了脑卒中入院患者的数据。我们在发病后的第一周内进行了全面的认知评估，包括基于《精神障碍诊断与统计手册》第五版的谵妄诊断。我们使用多因素逻辑回归分析报告了谵妄的比例以及与谵妄相关的临床和人口统计学因素。结果- 在 708 例患者中，年龄中位数为 71 岁（四分位距，59-80），708 例中有 187 例（26.4%；95%可信区间，23.0-30.0）发生了谵妄。在 395 例具有完整危险因素数据的患者中（105 例谵妄），与谵妄独立相关的因素有：年龄（比值比，1.05；95%可信区间，1.03-1.08）、药物/酒精滥用（比值比，2.64；95%可信区间，1.10-6.26）和卒中严重程度（比值比，1.22；95%可信区间，1.14-1.31）。结论- 急性脑卒中患者中谵妄很常见，每 4 人中就有 1 人发生。使用发病前和卒中特有的因素，可能可以预测高危人群。临床试验注册- 网址：researchregistry.com。方案编号：1147。
