Publication details

Delirium in stroke and surgical patients

Authors

BEDNAŘÍK Josef HALUZOVÁ Adéla KOŠŤÁLOVÁ Milena VOHÁŇKA Stanislav MITÁŠ Ladislav RYBA Luděk

Year of publication 2008
Type Article in Proceedings
Conference European Journal of Neurology
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords delirium; stroke; surgical patients
Description Aim: The aim of our study is to investigate the frequency, type and risk factors for delirium in the acute stage of stroke and after surgical intervention, using a specific diagnostic tool designed for the serial delirium assessment in the ICU setting: the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Methods: A cohort prospective observational study was performed in stroke patients admitted to the University Hospital within 24 hours after the stroke onset and in a group of patients who underwent planned surgery for spondylosis or pulmonary lesions. The data from the first 65 consecutive acute stroke patients (aged 72.1 + 11.1 years; 33 women and 32 men) and from 14 surgical patients (aged 62.5 + 10.7 years; 4 women and 10 men) were preliminary analysed in this pilot study. Results: An episode of delirium was observed in 31 acute stroke patients (48 %). The CAM-ICU showed a sensitivity of 98.9%. The mean duration of the delirious episode was 6.4 + 5.6, range 2-19 days, with the beginning 1-5 days after the onset of stroke. Delirium was significantly associated with pre-stroke dementia, age > 75 years, right hemisphere stroke, intracerebral haemorrhage and male gender. There was no episode of delirium observed in the surgical control group. Conclusion: Delirium is a frequent condition in acute stroke patients, if serially assessed on a daily basis with a validated diagnostic instrument. Beside various risk factors, stroke itself serve as an important risk factor for delirium compared to great surgery.
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