Kneihsl Markus, Berger Natalie, Sumerauer Stefan, Asenbaum-Nan Susanne, Höger Franz Stefan, Gattringer Thomas, Enzinger Christian, Aigner Martin, Ferrari Julia, Lang Wilfried
Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, Graz A-8036, Austria.
Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Ther Adv Neurol Disord. 2024 Aug 19;17:17562864241258788. doi: 10.1177/17562864241258788. eCollection 2024.
Delirium is a common complication in acute stroke patients, occurring in 15-35% of all stroke unit admissions and is associated with prolonged hospital stay and a poor post-stroke prognosis. Managing delirium in acute stroke patients necessitates an intensive and multiprofessional therapeutic approach, placing a significant burden on healthcare staff. However, dedicated practical recommendations for delirium management developed for the population of acute stroke patients are lacking. For this purpose, the Austrian Stroke Society, in cooperation with the Austrian Society of Neurology, the Austrian Society of Neurorehabilitation, and the Austrian Society of Psychiatry, Psychotherapy, and Psychosomatics has formulated an evidence-based position paper addressing the management of delirium in acute stroke patients. The paper outlines practical recommendations on the three pillars of care in stroke patients with delirium: (a) Key aspects of delirium including stroke-specific delirium risk factors and delirium prediction scores are described. Moreover, a non-pharmacological delirium prevention bundle is presented. (b) The paper provides recommendations on timing and frequency of delirium screening to ensure early of delirium in acute stroke patients. Moreover, it reports on the use of different delirium screening tools in stroke populations. (c) An overview of non-pharmacological and pharmacological strategies in patients with delirium and acute stroke is presented and summarized as key recommendation statements.
谵妄是急性卒中患者常见的并发症，在所有入住卒中单元的患者中发生率为15%至35%，且与住院时间延长及卒中后预后不良相关。对急性卒中患者的谵妄进行管理需要采取强化的多专业治疗方法，给医护人员带来了沉重负担。然而，目前缺乏专门针对急性卒中患者制定的谵妄管理实用建议。为此，奥地利卒中协会与奥地利神经病学协会、奥地利神经康复协会以及奥地利精神病学、心理治疗与身心医学协会合作，制定了一份基于证据的立场文件，阐述急性卒中患者谵妄的管理。该文件概述了谵妄性卒中患者护理三大支柱方面的实用建议：(a)描述了谵妄的关键方面，包括卒中特异性谵妄危险因素和谵妄预测评分。此外，还介绍了一个非药物性谵妄预防方案。(b)本文提供了谵妄筛查的时间和频率建议，以确保在急性卒中患者中早期发现谵妄。此外，还报告了在卒中人群中使用不同谵妄筛查工具的情况。(c)介绍并总结了谵妄性急性卒中患者的非药物和药物治疗策略，并将其作为关键推荐声明。
