Abstract WP118: Characteristics And Short-term Outcomes Of Delirium After Acute Ischemic Stroke

Abstract

Background: Delirium after acute ischemic stroke is a common clinical occurrence, associated with longer hospital admissions, worse functional outcomes, and increased mortality. We aim in a prospective study to assess the characteristics and risk factors for delirium after acute ischemic stroke (AIS) in a US population. Methods: Between September 2019 and June 2021, patients diagnosed with AIS within 48 hrs of stroke onset were prospectively evaluated for delirium using the Confusion Assessment Method (CAM)-ICU daily for the first eight days of their hospital stay. Patients with severe stroke and expected mortality within the first month at the time of admission or with severe aphasia unable to follow commands were excluded. Data regarding demographics, co-morbidities, hospital stay, stroke metrics, lab work, and medications were analyzed. Results: Over 12 non-consecutive months (due to pandemic interruptions), we evaluated 213 patients, of which 179 could be assessed with the CAM-ICU. Delirium was present in 89 (49.7%), occurring within the first 24 hours of admission in 33.6% and for longer than one day in 32.0%. There were no statistically significant differences in age, gender, race, co-morbidities, or TOAST etiology among patients with and without delirium (Table 1). Patients with delirium had higher NIHSS and were more likely to receive tPA. Patients with delirium were more likely to be discharged to inpatient rehabilitation facilities than home (p=0.05). Only patients with delirium had unexpected mortality after admission, but this statistic failed to show significance. Conclusion: In a cohort of AIS patients without significant expected mortality on admission, the incidence of delirium is high. Our study confirms prior results demonstrating higher inpatient mortality, longer hospital admissions among patients with delirium, and more delirium in patients receiving tPA.