Delirium in acute stroke: A prospective, cross-sectional, cohort study
Correction(s) for this article
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Corrigendum
- Volume 28Issue 11European Journal of Neurology
- pages: 3873-3873
- First Published online: October 16, 2021
Corresponding Author
Eleonora Rollo
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Correspondence
Eleonora Rollo, Department of Neuroscience, IRCCS Fondazione Policlinico Universitario A. Gemelli; Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8 00168 Rome, Italy.
Email: [email protected]
Contribution: Data curation (equal), Formal analysis (equal), Investigation (equal), Project administration (equal), Validation (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorAntonio Callea
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Contribution: Data curation (equal), Investigation (equal), Project administration (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorValerio Brunetti
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorCatello Vollono
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorJessica Marotta
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Data curation (equal), Formal analysis (equal), Investigation (equal), Project administration (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorClaudio Imperatori
Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
Contribution: Conceptualization (equal), Investigation (equal), Software (equal), Validation (equal), Visualization (equal)
Search for more papers by this authorGiovanni Frisullo
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Formal analysis (equal), Investigation (equal), Supervision (equal), Visualization (equal)
Search for more papers by this authorAldobrando Broccolini
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Formal analysis (equal), Investigation (equal), Supervision (equal), Validation (equal)
Search for more papers by this authorGiacomo Della Marca
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Investigation (equal), Methodology (equal), Supervision (equal), Validation (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Eleonora Rollo
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Correspondence
Eleonora Rollo, Department of Neuroscience, IRCCS Fondazione Policlinico Universitario A. Gemelli; Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8 00168 Rome, Italy.
Email: [email protected]
Contribution: Data curation (equal), Formal analysis (equal), Investigation (equal), Project administration (equal), Validation (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorAntonio Callea
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Contribution: Data curation (equal), Investigation (equal), Project administration (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorValerio Brunetti
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorCatello Vollono
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorJessica Marotta
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Data curation (equal), Formal analysis (equal), Investigation (equal), Project administration (equal), Visualization (equal), Writing - original draft (equal)
Search for more papers by this authorClaudio Imperatori
Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
Contribution: Conceptualization (equal), Investigation (equal), Software (equal), Validation (equal), Visualization (equal)
Search for more papers by this authorGiovanni Frisullo
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Formal analysis (equal), Investigation (equal), Supervision (equal), Visualization (equal)
Search for more papers by this authorAldobrando Broccolini
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Formal analysis (equal), Investigation (equal), Supervision (equal), Validation (equal)
Search for more papers by this authorGiacomo Della Marca
Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Investigation (equal), Methodology (equal), Supervision (equal), Validation (equal), Writing - original draft (equal), Writing - review & editing (equal)
Search for more papers by this authorAbstract
Background and purpose
Delirium is a neuropsychiatric disorder of attention and awareness that develops over a short time and fluctuates in severity. Although delirium has been extensively studied in intensive care units, the incidence of delirium in stroke units and its predictors in stroke patients need further investigation. The endpoints of our study were incidence of delirium in acute stroke and the risk factors that predispose to this condition.
Methods
Patients were consecutively enrolled in a stroke unit from April to October 2020. Inclusion criteria were: age ≥18 years, acute stroke and National Institute of Health Stroke Scale (NIHSS) score ≥1 at the time of clinical assessment of delirium. Exclusion criteria were: transient ischemic attack; absence of neuroimaging evidence of brain lesion; cerebral venous thrombosis; subarachnoid hemorrhage; and clinical conditions requiring intensive care unit treatment. All patients were evaluated by means of Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method-Intensive Care Unit (CAM-ICU) scores at baseline, evaluations which were repeated within 72 h or when patients developed symptoms suggesting delirium.
Results
The overall incidence of delirium was 36/120 (30%). Delirium was associated with aphasia (odds ratio [OR] 9.77; confidence interval [CI] 1.2–79.6), chronic obstructive pulmonary disease (COPD; OR 16.67; CI 1.1–263.0), deep Fazekas score (OR 5.05; CI 1.7–14.8), and physical restraint (OR 45.02; CI 1.4–1411.5). Diabetes was associated with a lower incidence of delirium (OR 0.04; CI 0.026–0.7).
Conclusions
Nearly one-third of patients (30%) had delirium in the acute phase of stroke. This finding supports the notion that delirium is a common complication of stroke. Delirium was associated with speech disorder, leukoencephalopathy, COPD and early use of physical restraint.
CONFLICT OF INTEREST
The authors have no conflict of interest to disclose.
Open Research
DATA AVAILABILITY STATEMENT
Data are available on request.
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