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
. 2020 Jul 14;9(7):2232.
doi: 10.3390/jcm9072232.

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study)

Affiliations

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study)

Katarzyna Kowalska et al. J Clin Med. .

Abstract

Background: Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author's objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke.

Methods: A total of 750 consecutive patients with acute stroke or transient ischemic attack, were screened for delirium during hospitalization. Patients underwent mental health evaluation in hospital, 3 and 12 months post-stroke; depression, apathy, anxiety and anger were the outcomes measured at all evaluation check points.

Results: Delirium was an independent risk factor for depression (OR = 2.28, 95%CI 1.15-4.51, p = 0.017) and aggression (OR = 3.39, 95%CI 1.48-7.73, p = 0.004) at the hospital, for anxiety 3 months post-stroke (OR = 2.83, 95%CI 1.25-6.39, p = 0.012), and for apathy at the hospital (OR = 4.82, 95%CI 2.25-10.47, p < 0.001), after 3 (OR = 3.84, 95%CI 1.31-11.21, p = 0.014) and 12 months (OR = 4.95, 95%CI 1.68-14.54, p = 0.004) post stroke.

Conclusions: The results of this study confirm, that mental health problems are very frequent complications of stroke. Delirium in the acute phase of stroke influences mental health of patients. This effect is especially significant in the first months post-stroke and vanishes with time, which suggests that in-hospital delirium might not be a damaging occurrence in most measures of mental health problems from a long-term perspective.

Keywords: aggression; anxiety; apathy; depression; post-stroke delirium; stroke.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.

References

    1. Gustafson Y., Olsson T., Eriksson S., Asplund K., Bucht G. Acute confusional states (delirium) in stroke patients. Cerebrovasc. Dis. 1991;1:257–264. doi: 10.1159/000108852. - DOI
    1. Alvarez-Perez F.J., Paiva F. Prevalence and Risk Factors for Delirium in Acute Stroke Patients. A Retrospective 5-Years Clinical Series. J. Stroke Cerebrovasc. Dis. 2017;26:567–573. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.120. - DOI - PubMed
    1. Shi Q., Presutti R., Selchen D., Saposnik G. Delirium in acute stroke: A systematic review and meta-analysis. Stroke. 2012;43:645–649. doi: 10.1161/STROKEAHA.111.643726. - DOI - PubMed
    1. Pasińska P., Wilk A., Kowalska K., Szyper-Maciejowska A., Klimkowicz-Mrowiec A. The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS) J. Neurol. 2019;266:2710–2717. doi: 10.1007/s00415-019-09471-1. - DOI - PMC - PubMed
    1. Mansutti I., Saiani L., Palese A. Delirium in patients with ischaemic and haemorrhagic stroke: Findings from a scoping review. Eur. J. Cardiovasc. Nurs. 2019;18:435–448. doi: 10.1177/1474515119846226. - DOI - PubMed

LinkOut - more resources