Abstract TP117: NLR Does Not Predict The Development Of Delirium In AIS Stroke Patients With Higher Rates Of Reperfusion Therapies.

Abstract

Introduction: Stroke patients who develop delirium after their stroke can have worse cognitive and functional outcomes. Prior studies suggest that admission Neutrophil Lymphocyte ratio (NLR) is associated with the development of delirium in both ischemic (AIS) and hemorrhagic stroke geriatric patients. In this study we examine AIS patients for laboratory predictors of delirium. Methods: Between September 2019 and June 2021, patients diagnosed with AIS, within 48 hrs of last seen normal or time of onset and had expected mortality >1 month were prospectively evaluated for delirium using the Confusion Assessment Method (CAM)-ICU daily for the first 8 days of their hospital stay and at discharge. NLR ratio was derived from patients’ admission blood panel and were both evaluated as continuous variables and in quartiles. Results: During the study period, 213 patients were screened for delirium. Of these, 18 patients could not be evaluated by the CAM-ICU at any point during the first eight days and 99(50.5%) screened positive for delirium. Our patient population was younger and had higher rates of endovascular and thrombolytic therapy than prior studies. Similar to other studies, patients with delirium had more severe NIHSS score (Table 1), longer lengths of stay, were more likely to be discharged to inpatient rehab than home, and trended to higher inpatient mortality. However, there was no apparent association between NLR and the development of delirium. Conclusion: In our patient population of younger patients who were more likely to receive reperfusion therapies, we did not find that NLR is associated with delirium. These results warrant additional study, specifically if reperfusion therapies such as thrombectomy and thrombolysis change how the nature of delirium and its predictive variables.