J 2012

Towards a predictive model for post-stroke delirium

KOŠŤÁLOVÁ, Milena, Josef BEDNAŘÍK, Adéla MITÁŠOVÁ, Ladislav DUŠEK, Radka MICHALČÁKOVÁ et. al.

Basic information

Original name

Towards a predictive model for post-stroke delirium

Authors

KOŠŤÁLOVÁ, Milena (203 Czech Republic, guarantor, belonging to the institution), Josef BEDNAŘÍK (203 Czech Republic, belonging to the institution), Adéla MITÁŠOVÁ (203 Czech Republic, belonging to the institution), Ladislav DUŠEK (203 Czech Republic, belonging to the institution), Radka MICHALČÁKOVÁ (203 Czech Republic, belonging to the institution), Miloš KEŘKOVSKÝ (203 Czech Republic, belonging to the institution), Tomáš KAŠPÁREK (203 Czech Republic, belonging to the institution), Martina JEŽKOVÁ (203 Czech Republic, belonging to the institution), Petra BALABÁNOVÁ (203 Czech Republic, belonging to the institution) and Stanislav VOHÁŇKA (203 Czech Republic, belonging to the institution)

Edition

Brain Injury, London, Taylor & Francis, 2012, 0269-9052

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30000 3. Medical and Health Sciences

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.513

RIV identification code

RIV/00216224:14740/12:00060438

Organization unit

Central European Institute of Technology

DOI

UT WoS

000305135100007

Keywords in English

Delirium; stroke; risk factors; incidence; prediction

Tags

Tags

International impact
Změněno: 12/4/2013 13:32, Olga Křížová

Abstract

V originále

Primary objective: To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium. Research design: A prospective observational study in a cohort of consecutive patients with ischemic stroke or intracerebral haematoma admitted within 24 hours of stroke onset. Methods: Patients were assessed daily for delirium during the first week by means of DSM-IV criteria and risk factors were recorded. Results: One hundred patients completed a 7-day evaluation (47 women and 53 men, median age 77 years). An episode of delirium was detected in 43 patients (43%). Using multivariate logistic regression, a predictive statistical model was developed that utilized independent risk factors: age (OR = 1.08; 95% CI = 1.02-1.15); intracerebral haemorrhage (OR = 6.11; 95% CI = 1.62-22.98), lesion volume > 40 ccm (OR = 3.99; 95% CI = 1.29-12.39) and either elevated gamma-glytamyl transferase (OR = 4.88; 95% CI = 1.45-16.35) and elevated serum bilirubin (OR = 3.70; 95% CI = 1.32-10.38) or maximum sequential organ failure assessment score >2 (OR = 3.33; 95% CI = 1.06-10.45) with acceptable sensitivity and specificity (69.0% and 80.7%). In ischemic strokes, total anterior circulation infarctions were more frequently associated with delirium (73.3% developed delirium) compared with the remainder of the groups combined (p = 0.004; OR = 6.66; 95% CI = 1.85-24.01). Conclusion: Higher age, metabolic disturbances, intracerebral haemorrhage and larger ischemic hemispheric strokes increase the risk of post-stroke delirium.

Links

MSM0021622404, plan (intention)
Name: Vnitřní organizace a neurobiologické mechanismy funkčních systémů CNS
Investor: Ministry of Education, Youth and Sports of the CR, The internal organisation and neurobiological mechanisms of functional CNS systems under normal and pathological conditions.
NS10216, research and development project
Name: Diagnostika a patofyziologie deliria v intenzivní a pooperační péči
Investor: Ministry of Health of the CR