Email this article Medical and social consequences of confusion syndrome that developed in the acute period of ischemic stroke
- Authors: Khlystov Y.V.1, Tsygan N.V.1, Kolomentsev S.V.1, Kurasov E.S.1, Odinak M.M.1, Litvinenko I.V.1
-
Affiliations:
- Military Medical Academy
- Issue: Vol 42, No 4 (2023)
- Pages: 377-382
- Section: Original articles
- URL: https://journals.rcsi.science/RMMArep/article/view/264748
- DOI: https://doi.org/10.17816/rmmar609540
- ID: 264748
Cite item
Abstract
AIM: To assess the dynamics of cognitive functions in patients in whom the acute period of ischemic stroke was accompanied by the confusion syndrome, in comparison with patients in whom the acute period of stroke was not accompanied by the development of confusion. To assess the impact of clinical features of confusion syndrome on the development of post-stroke cognitive impairment, mortality, and patient care burden.
MATERIALS AND METHODS: The study involved 99 patients, 55 of whom developed severe confusion during the acute period of stroke, and 44 patients whose ischemic stroke was not complicated by the development of confusion syndrome. The groups were homogeneous in terms of the main etiological factors: age, degree of pre-stroke cognitive impairment. The study assessed the impact of the development of confusional syndrome on the outcome.
RESULTS: Confusion syndrome that develops in the acute period of ischemic stroke significantly increases the risk of developing or worsening existing cognitive impairment, mortality, dependence on care, and the burden on caregivers.
CONCLUSION: Being a serious complication, confusion syndrome requires monitoring of qualitative and quantitative indicators of consciousness in the acute period of ischemic stroke, prevention and, if detected, immediate correction of confusion syndrome.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Yuriy V. Khlystov
Military Medical Academy
Author for correspondence.
Email: khlysyura@yandex.ru
ORCID iD: 0000-0001-5620-5986
SPIN-code: 8208-5103
Scopus Author ID: 53663593100
assistant to the Head of the Сlinic
Russian Federation, Saint PetersburgNikolay V. Tsygan
Military Medical Academy
Email: 1860n@mail.ru
ORCID iD: 0000-0002-5881-2242
SPIN-code: 1006-2845
Scopus Author ID: 37066611200
ResearcherId: H-9132-2016
M.D., D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgSergey V. Kolomentsev
Military Medical Academy
Email: skolomencev@yandex.ru
ORCID iD: 0000-0002-3756-6214
SPIN-code: 6439-6701
M.D., PhD (Medicine)
Russian Federation, Saint PetersburgEvgeny S. Kurasov
Military Medical Academy
Email: doc4678@mail.ru
ORCID iD: 0000-0003-3616-6574
SPIN-code: 4961-0342
M.D., D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgMiroslav M. Odinak
Military Medical Academy
Email: odinak@rambler.ru
ORCID iD: 0000-0002-7314-7711
SPIN-code: 1155-9732
Scopus Author ID: 7003327776
ResearcherId: I-6024-2016
M.D., Corresponding Member of the Russian Academy of Sciences, D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgIgor' V. Litvinenko
Military Medical Academy
Email: litvinenkoiv@rambler.ru
ORCID iD: 0000-0001-8988-3011
SPIN-code: 6112-2792
Scopus Author ID: 35734354000
ResearcherId: F-9120-2013
M.D., D.Sc. (Medicine), Professor
Russian Federation, Saint PetersburgReferences
- Dahl MH, Ronning OM, Thommessen B. Delirium in acute stroke — prevalence and risk factors. Acta Neurol Scand Suppl. 2010;22(190):39–43. doi: 10.1111/j.1600-0404.2010.01374.x
- Gustafson Y, Olsson T, Erikkson S, et. al. Acute confusional state (delirium) in stroke patients. Cerebrovasc Dis. 1991;1(1):257–264. doi: 10.1159/000108852
- Miu DK, Yeung JC. Incidence of post-stroke delirium and 1-year outcome. Geriatrics and Gerontology International. 2012;13(1): 123–129. doi: 10.1111/j.1447-0594.2012.00871.x
- Nydahl P, Margraf NG, Ewers A. [Delirium in stroke patients: Critical analysis of statistical procedures for the identification of risk factors]. Med Klin Intensivmed Notfmed. 2017;112(3):258–264. (In German) doi: 10.1007/s00063-016-0257-6
- Qu J, Chen Y, Luo G, et al. Delirium in the acute phase of ischemic stroke: incidence, risk factors, and effects on functional outcome. J Stroke Cerebrovasc Dis. 2018;27(10):2641–2647. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.034
- Pasińska P, Wilk A, Kowalska K, et al. The long-term prognosis of patients with delirium in the acute phase of stroke: PRospective Observational POLIsh Study (PROPOLIS). J Neurol. 2019;266(11): 2710–2717. doi: 10.1007/s00415-019-09471-1
- Barman A, Pradhan D, Bhattacharyya P, et al. Diagnostic accuracy of delirium assessment methods in critical care patients. J Crit Care. 2018;44:82–86. doi: 10.1016/j.jcrc.2017.10.013
- Vaynshenker YuI, Cinzerling VA, Melyucheva LA, et al. Multipattern botulinum toxin therapy of post-comatose long-term consciousness disorders: central effects. Bulletin of the Russian Military Medical Academy. 2019;(2(66)):78–87. (In Russ.)
- Litvinenko IV, Odinak MM, Khlystov YuV, et al. Efficacy and safety of rivastigmine (exelon) in the confusion syndrome in the acute phase of ischemic stroke. The Korsakov’s Journal of Neurology and Psychiatry. 2010;110(11-2):36–41. (In Russ.)
- Litvinenko IV, Odinak MM, Mogil’naya VI, Emelin AYu. Efficacy and safety of galantamine (reminyl) in the treatment of dementia in patients with Parkinson’s disease (open-lable controlled trial). The Korsakov’s Journal of Neurology and Psychiatry. 2007;107(12): 25–34. (In Russ.)
- Ojagbemi A, Ffytche DH. Are stroke survivors with delirium at higher risk of post-stroke dementia? Current evidence and future directions. Int J Geriatr Psychiatry. 2016;31(7):1289–1294. doi: 10.1002/gps.4506
- Droś J, Kowalska K, Pasińska P, et al. Delirium Post-Stroke-Influence on Post-Stroke Dementia (Research Study-Part of the PROPOLIS Study). Clin Med. 2020;9(7):2165. doi: 10.3390/jcm9072165
- Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113(12):941–948. doi: 10.7326/0003-4819-113-12-941
- Trzepacz PT, Baker RW., Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988;23(12):89–97. doi: 10.1007/springerreference_169912
- Trzepacz PT. The Delirium Rating Scale. Its use in consultation-liaison research. Psychosomatics. 1999;40(3):193–204. doi: 10.1016/s0033-3182(99)71235-1
- Folstein MF, McHugh PR. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6
- Dubois B, Slachevsky A, Litvan I, et al. The FAB: A frontal assessment battery at bedside. Neurology. 2000;55(11):1621–1626. doi: 10.1212/wnl.55.11.1621
- Sunderland T. Clock drawing in Alzheimer’s disease: A novel measure of dementia severity. J Am Geriatr Soc. 1989;37(8):725–729. doi: 10.1111/j.1532-5415.1989.tb02233.x
- Dubois B, Touchon J, Portet F, et al. [«The 5 words»: a simple and sensitive test for the diagnosis of Alzheimer’s disease]. Presse Med. 2002;31(36):1696–1699. (In French)
- Jorm AF, Jacomb PA. The informant questionnaire on cognitive decline in the elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989;19(4): 1015–1022. doi: 10.1017/s0033291700005742
- Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi: 10.1037/t03589-000
- Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–655. doi: 10.1093/geront/20.6.649
Supplementary files
