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The evaluation of delirium post-stroke

✍ Scribed by John Mc Manus; Rohan Pathansali; Hardi Hassan; Emma Ouldred; Derek Cooper; Robert Stewart; Alastair Macdonald; Stephen Jackson

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
73 KB
Volume
24
Category
Article
ISSN
0885-6230

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✦ Synopsis

Abstract

Objective

The aim of this study was to assess and compare the Confusion Assessment Method (CAM) and the Delirium Rating Scale (DRS) in the detection of delirium in the acute stroke setting, when used by a non‐psychiatrist doctor.

Methods

Consecutive participants within 4 days of an acute stroke were screened for delirium using the CAM and the DRS. Patients also had a Mini‐Mental State Examination at each assessment. Patients were screened weekly for a maximum of 4 weeks. The CAM and DRS were compared against each other with respect to agreement and applicability.

Results

Of 110 eligible patients, 82 were recruited over a 7 month period. Delirium developed in 23 patients (28%), 21 of whom developed delirium during week 1. We found high agreement between the CAM and the DRS in the detection of stroke in the acute stroke setting (κ values 0.97, 0.86, 0.79 and 1 at weeks 1, 2, 3 and 4, respectively). In addition, there was strong correlation between low MMSE scores (MMSE less that 10) and delirium (κ scores 1.0, 0.82, 0.83 and 1.0 at weeks 1, 2, 3 and 4, respectively).

Conclusions

Delirium is a common complication post‐stroke. The CAM is equivalent to the DRS in the acute stroke setting when used by a trained non‐psychiatrist. A low MMSE score may have a small benefit in identifying patients that are at risk of having delirium. Copyright © 2009 John Wiley & Sons, Ltd.

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