scholarly journals Delirium and subsyndromal delirium are associated with the long-term risk of death after ischaemic stroke

Author(s):  
Elzbieta Klimiec-Moskal ◽  
Agnieszka Slowik ◽  
Tomasz Dziedzic

Abstract Background Post-stroke delirium has a negative impact on functional outcome. We explored if there is any association between delirium, subsyndromal delirium and long-term mortality after ischaemic stroke and transient ischaemic attack. Methods We included 564 patients with ischaemic stroke or transient ischaemic attack. We assessed symptoms of delirium during the first 7 days after admission. We used Cox proportional hazards models to analyse all-cause mortality during the first 5 years after stroke. Results We diagnosed delirium in 23.4% and subsyndromal delirium in 10.3% of patients. During the follow-up, 72.7% of patients with delirium, 51.7% of patients with subsyndromal delirium and 22.7% of patients without delirious symptoms died (P < 0.001). Patients with subsyndromal delirium and delirium had higher risk of death in the multivariate analysis (HR 1.72, 95% CI 1.11–2.68, P = 0.016 and HR 3.30, 95% CI 2.29–4.76, P < 0.001, respectively). Conclusions Post-stroke delirium is associated with long-term mortality. Patients with subsyndromal delirium are at the intermediate risk of death.

BMJ Open ◽  
2013 ◽  
Vol 3 (10) ◽  
pp. e003724 ◽  
Author(s):  
Christian Ovesen ◽  
Annemette Abild ◽  
Anders Fogh Christensen ◽  
Sverre Rosenbaum ◽  
Christine Krarup Hansen ◽  
...  

2020 ◽  
pp. svn-2020-000372
Author(s):  
Shreyansh Shah ◽  
Li Liang ◽  
Durgesh Bhandary ◽  
Saga Johansson ◽  
Eric E Smith ◽  
...  

BackgroundLong-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack (TIA) and role of ABCD2 score in identifying high-risk individuals are not studied.MethodsWe identified 40 825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines (GWTG)-Stroke hospital and classified them using ABCD2 score. Proportional hazards models were used to assess 1-year event rates of mortality and rehospitalisation (all-cause, ischaemic stroke, haemorrhagic stroke, myocardial infarction, and gastrointestinal and intracranial haemorrhage) for high-risk versus low-risk groups adjusted for patient and hospital characteristics.ResultsOf the 40 825 patients, 35 118 (86%) were high risk (ABCD2 ≥4) and 5707 (14%) were low risk (ABCD2=0–3). Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%, 44.3% were rehospitalised for any reason and 3.6% were readmitted due to stroke. Patients with ABCD2 score ≥4 had higher mortality at 1 year than not (adjusted HR 1.18, 95% CI 1.07 to 1.30). Adjusted risks for ischaemic stroke, all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD2 score ≥4 vs 0–3. In contrast, haemorrhagic stroke, myocardial infarction, gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD2 score.ConclusionsThis study validates the use of ABCD2 score for long-term risk assessment after TIA in patients aged 65 years and older. Attentive efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.


2016 ◽  
Vol 23 (8) ◽  
pp. 1262-1268 ◽  
Author(s):  
N. A. M. M. Maaijwee ◽  
I. Tendolkar ◽  
L. C. A. Rutten-Jacobs ◽  
R. M. Arntz ◽  
P. Schaapsmeerders ◽  
...  

The Lancet ◽  
2005 ◽  
Vol 365 (9477) ◽  
pp. 2098-2104 ◽  
Author(s):  
I van Wijk ◽  
LJ Kappelle ◽  
J van Gijn ◽  
PJ Koudstaal ◽  
CL Franke ◽  
...  

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