title: Towards a predictive model for post-stroke delirium.
abstract: OBJECTIVE
  To assess predisposing and precipitating risk factors and create a predictive model for post-stroke delirium.
  
  
  METHODS
  A prospective observational study in a cohort of consecutive patients with ischemic stroke or intracerebral haematoma admitted within 24 hours of stroke onset.
  
  
  METHODS
  Patients were assessed daily for delirium during the first week by means of DSM-IV criteria and risk factors were recorded.
  
  
  RESULTS
  One hundred patients completed a 7-day evaluation (47 women and 53 men, median age 77 years). An episode of delirium was detected in 43 patients (43%). Using multivariate logistic regression, a predictive statistical model was developed that utilized independent risk factors: age (OR = 1.08; 95% CI = 1.02-1.15); intracerebral haemorrhage (OR = 6.11; 95% CI = 1.62-22.98), lesion volume > 40 ccm (OR = 3.99; 95% CI = 1.29-12.39) and either elevated gamma-glytamyl transferase (OR = 4.88; 95% CI = 1.45-16.35) and elevated serum bilirubin (OR = 3.70; 95% CI = 1.32-10.38) or maximum sequential organ failure assessment score >2 (OR = 3.33; 95% CI = 1.06-10.45) with acceptable sensitivity and specificity (69.0% and 80.7%). In ischemic strokes, total anterior circulation infarctions were more frequently associated with delirium (73.3% developed delirium) compared with the remainder of the groups combined (p = 0.004; OR = 6.66; 95% CI = 1.85-24.01).
  
  
  CONCLUSIONS
  Higher age, metabolic disturbances, intracerebral haemorrhage and larger ischemic hemispheric strokes increase the risk of post-stroke delirium.
authors.affiliation: Department of Neurology, University Hospital and Masaryk University, Brno, Czech Republic.
authors.forename: Milena
authors.initials: M
authors.lastname: Kostalova
authors.forename: Josef
authors.initials: J
authors.lastname: Bednarik
authors.forename: Adela
authors.initials: A
authors.lastname: Mitasova
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dušek
authors.forename: Radka
authors.initials: R
authors.lastname: Michalcakova
authors.forename: Milos
authors.initials: M
authors.lastname: Kerkovsky
authors.forename: Tomas
authors.initials: T
authors.lastname: Kasparek
authors.forename: Martina
authors.initials: M
authors.lastname: Jezkova
authors.forename: Petra
authors.initials: P
authors.lastname: Balabanova
authors.forename: Stanislav
authors.initials: S
authors.lastname: Vohanka
mesh_terms: D000367:Age Factors; D000368:Aged; D001663:Bilirubin / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003693:Delirium / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D015996:Survival Rate; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D001663:Bilirubin