title: Neuropsychiatric symptoms during 24 hours after dobutamine-atropine stress testing: a prospective study in 1,006 patients.
abstract: BACKGROUND
  The aim of this study was to investigate the incidence and predictors of neuropsychiatric (NP) symptoms during 24 hours after dobutamine-atropine stress testing (DST).
  
  
  METHODS
  Consecutive outpatients undergoing DST were asked to return a questionnaire regarding symptoms during the following 24 hours. Trained registered nurses administered the Delirium Observation Screening Scale before and after DST. To assess baseline symptoms in a control group, consecutive patients referred for DST completed the questionnaire regarding their symptoms during the 24 hours before DST.
  
  
  RESULTS
  A total of 1,006 patients were included (mean age, 67 ± 12 years; 462 [46%] women). Of the 750 patients who returned questionnaires, 53 patients (7.1%) reported NP symptoms. Among the 199 controls, three patients (1.5%) reported NP symptoms. Symptoms were usually mild and resolved spontaneously. Independent predictors of NP symptoms were atropine dose ≥ 1 mg (odds ratio [OR], 7.69; 95% confidence interval [CI], 4.13-14.81), prior NP disorder (OR, 2.11; 95% CI, 1.11-4.02), positive Delirium Observation Screening Scale result (OR, 4.89; 95% CI, 1.21-18.09), and body mass index < 24 kg/m(2) (OR, 2.37; 95% CI, 1.10-4.90).
  
  
  CONCLUSIONS
  Although usually mild, NP symptoms were nearly fivefold more common after DST (P < .001). Patients who had received ≥ 1 mg atropine and those with underlying NP disease, positive Delirium Observation Screening Scale results, or lower body mass indexes are at increased risk.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: Punsak
authors.initials: P
authors.lastname: Wuthiwaropas
authors.forename: Julie A
authors.initials: JA
authors.lastname: Wiste
authors.forename: Robert B
authors.initials: RB
authors.lastname: McCully
authors.forename: Garvan C
authors.initials: GC
authors.lastname: Kane
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Scott
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
mesh_terms: D000368:Aged; D001285:Atropine / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003693:Delirium / Q000209:etiology*; D004280:Dobutamine / Q000009:adverse effects*; D025401:Echocardiography, Stress / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine; D001285:Atropine