open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-01-13
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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

Hasan Hüseyin Kozak, Faruk Uğuz, İbrahim Kılınç, Ali Ulvi Uca, Osman Serhat Tokgöz, Zehra Akpınar, Nejla Özer
DOI: 10.1016/j.pjnns.2016.10.004
·
Neurol Neurochir Pol 2017;51(1):38-44.

open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-01-13

Abstract

Background

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.

Objective

Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS).

Methods

Sixty 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.

Results

Eleven (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

Background

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.

Objective

Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS).

Methods

Sixty 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.

Results

Eleven (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.

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Keywords

Delirium, Inflammation, Cytokine, Non-intensive care stroke unit, Acute ischemic stroke

About this article
Title

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

Vol 51, No 1 (2017)

Pages

38-44

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

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