Medical and social consequences of confusion syndrome that developed in the acute period of ischemic stroke
Yuriy V. Khlystov , Nikolay V. Tsygan , Sergey V. Kolomentsev , Evgeny S. Kurasov , Miroslav M. Odinak , Igor' V. Litvinenko
Russian Military Medical Academy Reports ›› 2023, Vol. 42 ›› Issue (4) : 377 -382.
Medical and social consequences of confusion syndrome that developed in the acute period of ischemic stroke
AIM: To assess the dynamics of cognitive functions in patients in whom the acute period of ischemic stroke was accompanied by the confusion syndrome, in comparison with patients in whom the acute period of stroke was not accompanied by the development of confusion. To assess the impact of clinical features of confusion syndrome on the development of post-stroke cognitive impairment, mortality, and patient care burden.
MATERIALS AND METHODS: The study involved 99 patients, 55 of whom developed severe confusion during the acute period of stroke, and 44 patients whose ischemic stroke was not complicated by the development of confusion syndrome. The groups were homogeneous in terms of the main etiological factors: age, degree of pre-stroke cognitive impairment. The study assessed the impact of the development of confusional syndrome on the outcome.
RESULTS: Confusion syndrome that develops in the acute period of ischemic stroke significantly increases the risk of developing or worsening existing cognitive impairment, mortality, dependence on care, and the burden on caregivers.
CONCLUSION: Being a serious complication, confusion syndrome requires monitoring of qualitative and quantitative indicators of consciousness in the acute period of ischemic stroke, prevention and, if detected, immediate correction of confusion syndrome.
cognition disorders / confusion syndrome / delirium / dementia / ischemic stroke / mortality / nurse
| [1] |
Dahl MH, Ronning OM, Thommessen B. Delirium in acute stroke — prevalence and risk factors. Acta Neurol Scand Suppl. 2010;22(190):39–43. DOI: 10.1111/j.1600-0404.2010.01374.x |
| [2] |
Dahl M.H., Ronning O.M., Thommessen B. Delirium in acute stroke — prevalence and risk factors // Acta Neurol. Scand. Suppl. 2010. Vol. 122, No. 190. P. 39–43. DOI: 10.1111/j.1600-0404.2010.01374.x |
| [3] |
Gustafson Y, Olsson T, Erikkson S, et. al. Acute confusional state (delirium) in stroke patients. Cerebrovasc Dis. 1991;1(1):257–264. DOI: 10.1159/000108852 |
| [4] |
Gustafson Y., Olsson T., Erikkson S., et. al. Acute confusional state (delirium) in stroke patients // Cerebrovasc. Dis. 1991. Vol. 1, No. 1. P. 257–264. DOI: 10.1159/000108852 |
| [5] |
Miu DK, Yeung JC. Incidence of post-stroke delirium and 1-year outcome. Geriatrics and Gerontology International. 2012;13(1): 123–129. DOI: 10.1111/j.1447-0594.2012.00871.x |
| [6] |
Miu D.K., Yeung J.C. Incidence of post-stroke delirium and 1-year outcome // Geriatrics and Gerontology International. 2012. Vol. 13, No. 1. P. 123–129. DOI: 10.1111/j.1447-0594.2012.00871.x |
| [7] |
Nydahl P, Margraf NG, Ewers A. [Delirium in stroke patients: Critical analysis of statistical procedures for the identification of risk factors]. Med Klin Intensivmed Notfmed. 2017;112(3):258–264. (In German) DOI: 10.1007/s00063-016-0257-6 |
| [8] |
Nydahl P., Margraf N.G., Ewers A. [Delirium in stroke patients: Critical analysis of statistical procedures for the identification of risk factors] // Med. Klin. Intensivmed. Notfmed. 2017. Vol. 112, No. 3. P. 258–264. DOI: 10.1007/s00063-016-0257-6 |
| [9] |
Qu J, Chen Y, Luo G, et al. Delirium in the acute phase of ischemic stroke: incidence, risk factors, and effects on functional outcome. J Stroke Cerebrovasc Dis. 2018;27(10):2641–2647. DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.034 |
| [10] |
Qu J., Chen Y., Luo G., et al. Delirium in the acute phase of ischemic stroke: incidence, risk factors, and effects on functional outcome // J. Stroke Cerebrovasc. Dis. 2018. Vol. 27, No. 10. P. 2641–2647. DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.034 |
| [11] |
Pasińska P, Wilk A, Kowalska K, et al. The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS). J Neurol. 2019;266(11): 2710–2717. DOI: 10.1007/s00415-019-09471-1 |
| [12] |
Pasińska P., Wilk A., Kowalska K., et al. The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS) // J. Neurol. 2019. Vol. 266, No. 11. Р. 2710–2717. DOI: 10.1007/s00415-019-09471-1 |
| [13] |
Barman A, Pradhan D, Bhattacharyya P, et al. Diagnostic accuracy of delirium assessment methods in critical care patients. J Crit Care. 2018;44:82–86. DOI: 10.1016/j.jcrc.2017.10.013 |
| [14] |
Barman A., Pradhan D., Bhattacharyya P., et al. Diagnostic accuracy of delirium assessment methods in critical care patients // J. Crit. Care. 2018. Vol. 44. P. 82–86. DOI: 10.1016/j.jcrc.2017.10.013 |
| [15] |
Vaynshenker YuI, Cinzerling VA, Melyucheva LA, et al. Multipattern botulinum toxin therapy of post-comatose long-term consciousness disorders: central effects. Bulletin of the Russian Military Medical Academy. 2019;(2(66)):78–87. (In Russ.) |
| [16] |
Вайншенкер Ю.И., Цинзерлинг В.А., Мелючева Л.А., и др. Центральные эффекты мультипаттерной ботулинотерапии при посткоматозных длительных бессознательных состояниях // Вестник Российской военно-медицинской академии. 2019. № 2 (66). С. 78–87. |
| [17] |
Litvinenko IV, Odinak MM, Khlystov YuV, et al. Efficacy and safety of rivastigmine (exelon) in the confusion syndrome in the acute phase of ischemic stroke. The Korsakov’s Journal of Neurology and Psychiatry. 2010;110(11-2):36–41. (In Russ.) |
| [18] |
Литвиненко И.В., Одинак М.М., Хлыстов Ю.В., и др. Эффективность и безопасность ривастигмина (экселона) при синдроме спутанности сознания в остром периоде ишемического инсульта // Журнал неврологии и психиатрии им. C.C. Корсакова. 2010. Т. 110, № 11-2. С. 36–41. |
| [19] |
Litvinenko IV, Odinak MM, Mogil’naya VI, Emelin AYu. Efficacy and safety of galantamine (reminyl) in the treatment of dementia in patients with Parkinson’s disease (open-lable controlled trial). The Korsakov’s Journal of Neurology and Psychiatry. 2007;107(12): 25–34. (In Russ.) |
| [20] |
Литвиненко И.В., Одинак М.М., Могильная В.И., Емелин А.Ю. Эффективность и безопасность применения галантамина (реминила) при деменции у пациентов с болезнью Паркинсона (открытое контролируемое исследование) // Журнал неврологии и психиатрии им. C.C. Корсакова. 2007. Т. 107, № 12. С. 25–34. |
| [21] |
Ojagbemi A, Ffytche DH. Are stroke survivors with delirium at higher risk of post-stroke dementia? Current evidence and future directions. Int J Geriatr Psychiatry. 2016;31(7):1289–1294. DOI: 10.1002/gps.4506 |
| [22] |
Ojagbemi A., Ffytche D.H. Are stroke survivors with delirium at higher risk of post-stroke dementia? Current evidence and future directions // Int. J. Geriatr. Psychiatry. 2016. Vol. 31, No. 7. Р. 1289–1294. DOI: 10.1002/gps.4506 |
| [23] |
Droś J, Kowalska K, Pasińska P, et al. Delirium Post-Stroke-Influence on Post-Stroke Dementia (Research Study-Part of the PROPOLIS Study). Clin Med. 2020;9(7):2165. DOI: 10.3390/jcm9072165 |
| [24] |
Droś J., Kowalska K., Pasińska P., et al. Delirium Post-Stroke-Influence on Post-Stroke Dementia (Research Study-Part of the PROPOLIS Study) // Clin. Med. 2020. Vol. 9, No. 7. Р. 2165. DOI: 10.3390/jcm9072165 |
| [25] |
Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–948. DOI: 10.7326/0003-4819-113-12-941 |
| [26] |
Inouye S.K., van Dyck C.H., Alessi C.A., et al. Clarifying confusion: The confusion assessment method. A new method for detection of delirium // Ann. Intern. Med. 1990. Vol. 113, No. 12. P. 941–948. DOI: 10.7326/0003-4819-113-12-941 |
| [27] |
Trzepacz PT, Baker RW., Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988;23(12):89–97. DOI: 10.1007/springerreference_169912 |
| [28] |
Trzepacz P.T., Baker R.W., Greenhouse J. A symptom rating scale for delirium // Psychiatry Res. 1988. Vol. 23, No. 12. P. 89–97. DOI: 10.1007/springerreference_169912 |
| [29] |
Trzepacz PT. The Delirium Rating Scale. Its use in consultation-liaison research. Psychosomatics. 1999;40(3):193–204. DOI: 10.1016/s0033-3182(99)71235-1 |
| [30] |
Trzepacz P.T. The Delirium Rating Scale. Its use in consultation-liaison research // Psychosomatics. 1999. Vol. 40, No. 3. P. 193–204. DOI: 10.1016/s0033-3182(99)71235-1 |
| [31] |
Folstein MF, McHugh PR. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198. DOI: 10.1016/0022-3956(75)90026-6 |
| [32] |
Folstein M.F., McHugh P.R. A practical method for grading the cognitive state of patients for the clinician // J. Psychiatr. Res. 1975. Vol. 12, No. 3. P. 189–198. DOI: 10.1016/0022-3956(75)90026-6 |
| [33] |
Dubois B, Slachevsky A, Litvan I, et al. The FAB: A frontal assessment battery at bedside. Neurology. 2000;55(11):1621–1626. DOI: 10.1212/wnl.55.11.1621 |
| [34] |
Dubois B., Slachevsky A., Litvan I., et al. The FAB: A frontal assessment battery at bedside // Neurology. 2000. Vol. 55, No. 11. P. 1621–1626. DOI: 10.1212/wnl.55.11.1621 |
| [35] |
Sunderland T. Clock drawing in Alzheimer’s disease: A novel measure of dementia severity. J Am Geriatr Soc. 1989;37(8):725–729. DOI: 10.1111/j.1532-5415.1989.tb02233.x |
| [36] |
Sunderland T. Clock drawing in Alzheimer’s disease: A novel measure of dementia severity // J. Am. Geriatr. Soc. 1989. Vol. 37, No. 8. P. 725–729. DOI: 10.1111/j.1532-5415.1989.tb02233.x |
| [37] |
Dubois B, Touchon J, Portet F, et al. [«The 5 words»: a simple and sensitive test for the diagnosis of Alzheimer’s disease]. Presse Med. 2002;31(36):1696–1699. (In French) |
| [38] |
Dubois B., Touchon J., Portet F., et al. [“The 5 words”: a simple and sensitive test for the diagnosis of Alzheimer’s disease] // Presse Med. 2002. Vol. 31, No. 36. P. 1696–1699. |
| [39] |
Jorm AF, Jacomb PA. The informant questionnaire on cognitive decline in the elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989;19(4): 1015–1022. DOI: 10.1017/s0033291700005742 |
| [40] |
Jorm A.F., Jacomb P.A. The informant questionnaire on cognitive decline in the elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms // Psychol. Med. 1989. Vol. 19, No. 4. P. 1015–1022. DOI: 10.1017/s0033291700005742 |
| [41] |
Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. DOI: 10.1037/t03589-000 |
| [42] |
Zigmond A.S., Snaith R.P. The Hospital Anxiety and Depression Scale // Acta Psychiatr. Scand. 1983. Vol. 67, No. 6. P. 361–370. DOI: 10.1037/t03589-000 |
| [43] |
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–655. DOI: 10.1093/geront/20.6.649 |
| [44] |
Zarit S.H., Reever K.E., Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden // Gerontologist. 1980. Vol. 20, No. 6. P. 649–655. DOI: 10.1093/geront/20.6.649 |
Eco-Vector
/
| 〈 |
|
〉 |