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Reperfusion therapy and risk of post-stroke delirium.
Czyzycki, Mateusz; Pera, Joanna; Dziedzic, Tomasz.
Afiliación
  • Czyzycki M; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
  • Pera J; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
  • Dziedzic T; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Neurol Res ; : 1-6, 2024 Sep 16.
Article en En | MEDLINE | ID: mdl-39284570
ABSTRACT

OBJECTIVES:

Delirium is a common and serious post-stroke complication. Early reperfusion by ameliorating brain damage could potentially prevent delirium after ischemic stroke, but the impact of this therapy on delirium remains unclear. We aimed to explore the association between reperfusion therapy (RT) and post-stroke delirium.

METHODS:

We retrospectively analyzed data from the PRospective Observational POLIsh Study on post-stroke delirium. Symptoms of delirium were examined during the first 7 days after admission and a diagnosis of delirium was made using Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. We used logistic regression to examine the association between RT and delirium.

RESULTS:

We included 301 acute stroke patients (median age 77; median NIHSS 14; 55.1% female). In the whole group of patients, RT was associated with a lower odds of delirium (34.2% vs 44.8%; adjusted OR 0.56, 95% CI 0.32-0.96, p = 0.035). There was a significant interaction between RT and pre-stroke cognitive status. As a result, RT was associated with a lower odds of delirium in patients without premorbid cognitive decline (28.8% vs 48.2%; adjusted OR 0.34, 95% CI 0.17-0.66, p = 0.002) and a higher odds of delirium in patients with pre-stroke cognitive decline (72.7% vs 41.0%; adjusted OR 3.55, 95% CI 1.03-12.20, p = 0.040).

DISCUSSION:

The association between RT and delirium is modified by pre-stroke cognitive status. In patients without cognitive decline, RT is associated with a lower likelihood of delirium. Delirium should be considered as a relevant outcome in future controlled trials.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Neurol Res Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Neurol Res Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Reino Unido