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Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers
Affiliations- Department of Neurology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
- Department of Clinical Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
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Abstract
Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers.
ObjectiveOur aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS).
MethodsSixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission.
ResultsEleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n=8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity.
Abstract
Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers.
ObjectiveOur aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS).
MethodsSixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission.
ResultsEleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n=8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity.
Keywords
Delirium, Inflammation, Cytokine, Non-intensive care stroke unit, Acute ischemic stroke
About this articleTitle
Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
38-44
Page views
311
Article views/downloads
541
DOI
10.1016/j.pjnns.2016.10.004
Bibliographic record
Neurol Neurochir Pol 2017;51(1):38-44.
Keywords
Delirium
Inflammation
Cytokine
Non-intensive care stroke unit
Acute ischemic stroke
Authors
Hasan Hüseyin Kozak
Faruk Uğuz
İbrahim Kılınç
Ali Ulvi Uca
Osman Serhat Tokgöz
Zehra Akpınar
Nejla Özer
