Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Nov;266(11):2710-2717.
doi: 10.1007/s00415-019-09471-1. Epub 2019 Jul 19.

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS)

Paulina Pasińska  1   2 , Aleksander Wilk  3 , Katarzyna Kowalska  2 , Aleksandra Szyper-Maciejowska  1 , Aleksandra Klimkowicz-Mrowiec  4   5
Affiliations
Observational Study

The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS)

Paulina Pasińska et al. J Neurol. 2019 Nov.

Abstract

Background and purpose: Delirium is a very common neurobehavioral complication after stroke, but its influence on long-term outcome is not well characterized. The objective of the study was to determine the prognostic significance of delirium for functional status, nursing home admission, and mortality in a large cohort of patients with delirium in the acute phase of stroke assessed 3 and 12 months after stroke.

Methods: All stroke survivors included in PROPOLIS were followed up (n = 682). Outcome data included: discharge destination, recurrence of stroke, cardiovascular complications, functional activity and mobility, nursing home admission, and mortality.

Results: Patients with delirium were discharged to another hospital or nursing home significantly more often than those presenting without delirium. The 3- and 12-month post-stroke mortality rates were higher in delirious patients (OR 6.41 CI 3.76-10.92; p < 0.001 and OR 5.17 CI 3.36-7.96; p < 0.001). When considering 3-month mortality, higher age, modified Rankin Scale prior to admission and temperature between 1 and 3 days after admission, as well delirium, pneumonia and more severe neurological deficits on admission were independent risk factors. For 12-month mortality, the independent risk factors were higher age and modified Rankin Scale post-stroke, delirium, and history of respiratory diseases prior to stroke. Patients with delirium were more likely to live in nursing homes 3 and 12 months after stroke and were more disabled than patients without delirium.

Conclusions: Delirium in acute phase of stroke negatively influences the long-term prognosis. A study addressing the effect of early recognition and treatment of identified modifiable risk factors for adverse long-term outcomes is urgently needed to decrease bad prognosis within this population.

Keywords: Delirium; Long-term prognosis; Mortality; Stroke.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flowchart of the study procedures
Fig. 2
Fig. 2
Kaplan–Meier curve demonstrating the cumulative mortality rate of patients with and without post-stroke delirium 3 and 12 months following discharge
See this image and copyright information in PMC

References

    1. McManus J, Pathansali R, Stewart R, Macdonald A, Jackson S. Delirium post-stroke. Age Ageing. 2007;36:613–618. doi: 10.1093/ageing/afm140. - DOI - PubMed
    1. Sheng AZ, Shen Q, Cordato D, Zhang YY, Yin Chan DK. Delirium within three days of stroke in a cohort of elderly patients. J Am Geriatr Soc. 2006;54:1192–1198. doi: 10.1111/j.1532-5415.2006.00806.x. - DOI - PubMed
    1. Miu DK, Yeung JC. Incidence of post-stroke delirium and 1-year outcome. Geriatr Gerontol Int. 2013;13:123–129. doi: 10.1111/j.1447-0594.2012.00871.x. - DOI - PubMed
    1. Dostovic Z, Smajlovic D, Ibrahimagic OC, Dostovic A. Mortality and functional disability of poststroke delirium. Mater Sociomed. 2018;30:95–97. doi: 10.5455/msm.2018.30.95-97. - DOI - PMC - PubMed
    1. Mc Manus JT, Pathansali R, Ouldred E, Stewart R, Jackson SH. Association of delirium post-stroke with early and late mortality. Age Ageing. 2011;40:271–274. doi: 10.1093/ageing/afq165. - DOI - PubMed

Publication types