Long-Term Cognitive Impairment Associated With Delirium in Acute Neurological Injury.
Abstract
To characterize the risk of long-term cognitive impairment associated with delirium in acute neurologic injury patients. We analyzed a 10-year cohort of adult acute neurologic injury patients (stroke and traumatic brain injury) without preexisting mild cognitive impairment or dementia, utilizing administrative databases. Patients were followed for in-hospital delirium and mild cognitive impairment or dementia. We report incidence and adjusted hazard ratios for mild cognitive impairment or dementia associated with delirium. Subgroups analyzed include acute neurologic injury categories, dementia subtypes, repeated delirium exposure, and age strata. We used state emergency department and state inpatient databases for New York, Florida, and California. All visits are included in the databases regardless of payer status. We included adult patients with diagnosis of stroke and traumatic brain injury as acute neurologic injury. Patients with preexisting mild cognitive impairment or dementia were excluded. None. Among 911,380 acute neurologic injury patients, 5.2% were diagnosed with delirium. Mild cognitive impairment or dementia incidence among delirium patients was approximately twice that of nondelirium patients. In adjusted models...Continue Reading
References
Delirium in acute stroke: a predictor of subsequent cognitive impairment? A two-year follow-up study
Evaluation of algorithms to identify delirium in administrative claims and drug utilization database
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Brain Injury & Trauma
brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.