Delirium is a predictor of stroke outcome independently of pneumoinia and urinary tract infection

Background and Aims Delirium and infections are common complications after ischemic stroke, associated with poor outcome. Since they are thought to be closely related, we aimed to investigate whether delirium is a predictor of length of hospital stay, unfavourable outcome and mortality at 3 months after stroke onset, independent of the development of pneumonia and urinary tract infection (UTI). Methods In a dataset of 514 patients with acute ischemic stroke admitted at the University Hospital Brussels within 24 hours after onset, delirium was diagnosed within the first week after stroke onset, based on the presence of the DSM-5 criteria, using a retrospective chart review method. Median length of hospital stay was used as cut-off for short versus long hospital stay. Unfavourable outcome was defined as having a mRS > 2 at 3 months. Multiple logistic regression analysis (MLRA) was used to identify independent predictors of long hospital stay, unfavourable outcome and mortality. Results 201 patients (39%) developed delirium. Median length of hospital stay of all patients was 9 days. MRLA showed that for length of hospital stay and unfavourable outcome, delirium has a predictive value independent of pneumonia, UTI, age and stroke severity with an odds ratio of 3.3 (95%CI = 2.1–5.2) and 3.8 (95%CI = 2.2–6.4) respectively. Delirium did not predict mortality in our study population. Conclusions Our results suggest that delirium is a predictor of length of hospital stay and unfavourable outcome, but not of mortality, at 3 months after ischemic stroke, even after adjustment for pneumonia and UTI.