and outcome Delirium in the acute phase after stroke : Incidence, risk factors,

ABSTRACT Objectives: This prospective cohort study assesses incidence of delirium after stroke. In addition,risk factors during the first week were assessed. Finally, outcome in relation to development ofdelirium was studied. Methods: A total of 527 consecutive patients with stroke (median age, 72 years; range, 29–96years) were screened for delirium during the first week after admission. We diagnosed deliriumwith the Confusion Assessment Method. Cognitive functioning prior to the stroke was assessedwith the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Neurologic defi-cits were assessed with the NIH Stroke Scale. Results: A total of 62 patients with stroke (11.8%) developed delirium during the first week ofadmission. Independent risk factors were preexisting cognitive decline (odds ratio [OR] forIQCODE above 50: 2.6, 95% confidence interval [CI] 1.2–5.7) and infection (OR 3.4, 95% CI1.7–6.8). Furthermore, right-sided hemispheric stroke (OR 2.0, 95% CI 1.0–3.0), anterior circu-lationlarge-vesselstroke(OR3.4,95%CI1.1–10.2),thehighesttertileoftheNIHStrokeScale(ORforhighestvslowesttertile15.1,95%CI3.3–69.0),andbrainatrophy(ORforhighestversuslowesttertile 2.7, 95% CI 1.1–6.8) increased the risk for delirium. Delirium was associated with a worseoutcomeintermsofdurationofhospitalization,mortality,andfunctionaloutcome.