Post-Stroke Confusion May Worsen Outcomes

Delirium following a stroke linked with a poorer patient outcome

January 24, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Delirium among hospitalized stroke patients is common with up to 30 percent of patients suffering from disorientation and temporarily altered mental status. Research suggests those patients may have worse outcomes.

In addition to poorer outcomes, stroke patients who suffer from delirium tend to have longer hospitals stays and are three times more likely to be discharged to a long-term care facility.

"Head to the hospital immediately if you suspect a stroke."

Dr. Gustavo Saposnik, senior author of the analysis and director of the Stroke Outcomes Research Center at St. Michael’s Hospital, noted that recognizing underlying problems that could lead to delirium could improve the prognosis of patients.

When delirium occurs a week to 10 days after a stroke, it could be related to the stroke, but is commonly related to other complications such as respiratory or urinary infection.

Patients more likely to suffer from delirium include older patients, those with other medical conditions and those who suffer larger strokes.

Investigators reviewed 10 studies that included more than 2,000 patients who were hospitalized following a stroke caused by vessel blockage or bleeding. Most of the patients were in stroke units at academic hospitals and may have had more complex conditions resulting in worse outcomes.

During the study, Canadian researchers analyzed four common outcomes in acute stroke patients with delirium, including the rate of patient deaths during hospital stays and 12 months later, the length of hospital stays and arrangements for care after discharge. Between 10 percent and 28 percent of the patients experienced delirium.

They found that patients suffering from delirium were 4.7 times more likely to die in the hospital or within a year of hospitalization. Their average hospital stays also were nine days longer than average, in part because they require additional medical evaluation and monitoring, and patients had a higher likelihood of being discharged to a facility for long-term care.

The review study was recently published in Stroke: Journal of the American Heart Association.