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The following is a summary of “Does ICU admission dysphagia independently contribute to delirium risk in ischemic stroke patients? Results from a cohort study,” published in the January 2024 issue of Psychiatry by Cheng et al.
In patients with ischemic stroke in the intensive care unit (ICU), the coexistence of delirium and dysphagia complicates their condition, potentially contributing to increased mortality rates and prolonged hospital stays. In contrast, the specific association between dysphagia and delirium remains unclear.
Researchers conducted a retrospective study to explore the relationship between dysphagia and delirium in ICU patients with ischemic stroke.
They analyzed adult patients diagnosed with ischemic stroke at a Boston medical center, identifying cases using the ninth and tenth revisions of the International Classification of Diseases. Dysphagia was defined through a positive bedside swallowing screen on the day of ICU admission, and delirium was assessed using the ICU Confusion Assessment Method and nursing notes. Logistic regression models were employed to examine the association between dysphagia and delirium, while causal mediation analysis was used to identify potential mediating variables.
The result showed that of 1,838 participants, with a median age of around 70 years, 50.5% were female. Delirium prevalence in the total population was 43.4%, higher in the dysphagia group (60.7% vs. 40.8%, P<0.001). Adjusting for confounding factors, logistic regression showed a significant association between dysphagia and increased delirium likelihood (OR: 1.48; 95% CI: 1.07–2.05; P=0.018; E-value = 1.73). Causal mediation analysis indicated serum albumin levels partially mediated the dysphagia-delirium association in critically ill patients with ischemic stroke (ACME: 0.02, 95% CI: 0.01 to 0.03; P<0.001).
Investigators concluded that ICU admission dysphagia independently increases the risk of delirium in patients with ischemic stroke. Early identification and intervention for dysphagia in this population may mitigate delirium risk, contributing to improved patient prognosis.
Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05520-w