Clinical and imaging correlated analysis of delirium in patients with acute ischemic stroke

QU Jian -feng; CHEN Yang-kun; LUO Gen-pei; ZHONG Huo-hua; YIN Han-peng; XIAO Wei-min

doi:10.3969/j.issn.1001-9448.2018.02.012

Abstract：Objective To investigate the clinical and MRI indicators of post -stroke delirium(PSD)in patients at acute phase after ischemic stroke.Methods A total of 251 patients with acute ischemic stroke participated in this study.All participants were screened for delirium during the first week after admission.We diagnosed delirium with the Confusion Assessment Method(CAM).Clinical and MRI variables were compared between the patient with PSD and with-out PSD.Logistic regressions were performed to find the risk factors of PSD.Results PSD was revealed in 34(15.7%) patients.Comparing with non-PSD group,patients with PSD had significantly elder age(69.5 ±16.7 vs.59.9 ±14.1, P<0.001),higher NIHSS score at admission[9(5-15)vs.4(1-7),P<0.001],morbidities of pre-stroke history (35.3%vs.13.8%,P=0.002)and infection complications(38.2% vs.9.2%, P<0.001).PSD was significantly more common in the large -artery atherosclerosis(LAA)form ischemic stroke(P =0.005).There were significant differences in the volume of infarction[11.03(4.065-71.5)vs.1.67(0.75-7.62), P<0.001], MTLA[2(0-5) vs.0(0-2),P<0.001]and left side cortical infarctions(47.1%vs.24.0%,P=0.005)between the PSD and non -PSD groups.Logistic regression analysis showed that left -side cortical infarction,MTLA,the NIHSS score on admission and infectious complications were significantly correlated with PSD.Conclusion PSD is common in acute phase after is-chemic stroke.Left-side cortical infarction,the degrees of MTLA,severity of neurological deficits,and infectious com-plications are the major determinants of PSD,suggesting that PSD may be associated with both the index stroke and preex-isting brain abnormalities.