Dataset Information

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study).

ABSTRACT: Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author's objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke. A total of 750 consecutive patients with acute stroke or transient ischemic attack, were screened for delirium during hospitalization. Patients underwent mental health evaluation in hospital, 3 and 12 months post-stroke; depression, apathy, anxiety and anger were the outcomes measured at all evaluation check points. Delirium was an independent risk factor for depression (OR = 2.28, 95%CI 1.15-4.51, p = 0.017) and aggression (OR = 3.39, 95%CI 1.48-7.73, p = 0.004) at the hospital, for anxiety 3 months post-stroke (OR = 2.83, 95%CI 1.25-6.39, p = 0.012), and for apathy at the hospital (OR = 4.82, 95%CI 2.25-10.47, p < 0.001), after 3 (OR = 3.84, 95%CI 1.31-11.21, p = 0.014) and 12 months (OR = 4.95, 95%CI 1.68-14.54, p = 0.004) post stroke. The results of this study confirm, that mental health problems are very frequent complications of stroke. Delirium in the acute phase of stroke influences mental health of patients. This effect is especially significant in the first months post-stroke and vanishes with time, which suggests that in-hospital delirium might not be a damaging occurrence in most measures of mental health problems from a long-term perspective.

SUBMITTER: Kowalska K

PROVIDER: S-EPMC7408940 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study).

Kowalska Katarzyna K Droś Jakub J Mazurek Małgorzata M Pasińska Paulina P Gorzkowska Agnieszka A Klimkowicz-Mrowiec Aleksandra A

Journal of clinical medicine 20200714 7

<h4>Background</h4>Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author's objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke.<h4>Methods</h4>A total of 750 consecutive patients with acute stroke or transient ischemic attack, were screened for delirium during hospitalization. Patients underwent mental health evaluation in h ...[more]

PMID: 32674417

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Project description:ObjectivesAnxiety and depression are common mental disorders in adults admitted to the ICU. Although depression increases postsurgical delirium and anxiety does not, their associations with ICU delirium in critically ill adults remain unclear. We evaluated the association between ICU baseline anxiety and depression and ICU delirium occurrence.DesignSubgroup analysis of a prospective cohort study.SettingSingle, 36-bed mixed ICU.PatientsNine-hundred ninety-one ICU patients admitted with or without delirium between July 2016 and February 2020; patients admitted after elective surgery or not assessed for anxiety/depression were excluded.InterventionNone.Measurements and main resultsThe Hospital Anxiety and Depression Scale questionnaire was administered at ICU admission to determine baseline anxiety and depression. All patients were assessed with the Confusion Assessment Method for the ICU (CAM-ICU) q8h; greater than or equal to 1 +CAM-ICU assessment and/or scheduled antipsychotic use represented a delirium day. Multivariable logistic and Quasi-Poisson regression models, adjusted for ICU days and nine delirium risk variables ("Pre-ICU": age, Charlson Comorbidity Index, cognitive impairment; "ICU baseline": Acute Physiology and Chronic Health Evaluation-IV, admission type; "Daily ICU": opioid and/or benzodiazepine use, Sequential Organ Failure Assessment score, coma), were used to evaluate associations between baseline anxiety and/or depression and ICU delirium. Among the 991 patients, 145 (14.6%) had both anxiety and depression, 78 (7.9%) had anxiety only, 91 (9.2%) had depression only, and 677 (68.3%) had neither. Delirium occurred in 406 of 991 total cohort (41.0%) patients; in the baseline anxiety and depression group, it occurred in 78 of 145 (53.8%), in the anxiety only group, 37 of 78 (47.4%), in the depression only group, 39 of 91 (42.9%), and in the group with neither in 252 of 677 (37.2%). Presence of both baseline anxiety and depression was associated with greater delirium occurrence (adjusted odds ratio, 1.99; 95% CI, 1.10-3.53; p = 0.02) and duration (adjusted risk ratio, 1.62; 95% CI, 1.17-2.23; p < 0.01).ConclusionsBaseline anxiety and depression are associated with increased ICU delirium occurrence and should be considered when delirium risk reduction strategies are being formulated.

Dataset Information

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study).

Publications

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study).

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