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Association between Delirium and Prehospitalization Medication in Poststroke Patients.

Association between Delirium and Prehospitalization Medication in Poststroke Patients.
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Hosoya R, Sato Y, Ishida E, Shibamoto H, Hino S, Yokote H, Kamata T,


Hosoya R, Sato Y, Ishida E, Shibamoto H, Hino S, Yokote H, Kamata T, (click to view)

Hosoya R, Sato Y, Ishida E, Shibamoto H, Hino S, Yokote H, Kamata T,

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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2018 03 27() pii 10.1016/j.jstrokecerebrovasdis.2018.02.038

Abstract
PURPOSE
Medication is an important risk factor for delirium; however, the association between delirium and prehospitalization medication is unclear. We investigated the association between prestroke medication and poststroke delirium.

MATERIALS AND METHODS
All patients hospitalized in the stroke care unit from September 2011 to September 2012 were selected, and their delirium symptoms, patient information, and pre- and poststroke medications were analyzed. Delirium was defined as a score of  4 or higher on the Intensive Care Delirium Screening Checklist. Factors that were related to delirium were extracted using univariate analysis, and the independent risk factors were determined using multivariate analysis.

RESULTS
Of the 269 patients analyzed, 97 (36%) experienced delirium. Univariate analysis revealed significant differences between the delirium and nondelirium groups in age, dementia, previous cerebrovascular disease, craniotomy, all insertion-tube types, and 6 categories of prestroke medication. Prestroke polypharmacy was associated with poststroke delirium (P = .002). Multivariate analysis showed that taking antianxiety agents or sleep aids was an independent risk factor for delirium (odds ratio: 3.17, 95% confidence interval: 1.16-8.82).

CONCLUSIONS
The present study suggests that prestroke medication affects the onset of poststroke delirium. These findings can contribute to the prediction and prevention of this condition.

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