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Journal of Nursing ›› 2018, Vol. 25 ›› Issue (22): 38-43.doi: 10.16460/j.issn1008-9969.2018.22.038

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Systematic Review and Meta-analysis of Risk Factors of Post Stroke Delirium

LI Zhena, CAO Jinga, LI Jia-qianb, WU Xin-juana   

  1. a. Dept. of Nursing Administration; b. Dept. of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
  • Received:2018-07-03 Published:2020-07-08

Abstract: Objective To conduct a systematic review and meta-analysis of risk factors for post stroke delirium (PSD)and provide reference for effective prevention of PSD. Methods Studies on risk factors for PSD from PubMed, EMbase, CINAHL, Cochrane Library, PsycINFO, CNKI, Wanfang, CBM, VIP before February 2018 were searched. Two reviewers independently assessed the quality of included studies. Data were combined by fixed or random effects models using Stata 14.0. Begg test combined with funnel plot was implemented to evaluate publication bias. Results Fourteen studies were concluded with 4,807 stroke patients, among which 784(16.31%) were diagnosed with delirium. The quality of studies was moderate or high. A total of 8 risk factors were involved. The OR for these factors was vision deficits 31.76 (95%CI:11.61~86.86), increased C-reactive protein 7.64 (95%CI:1.83~31.90), cognitive decline 7.48 (95%CI:3.63~15.42), anterior circulation infarction 5.24 (95%CI:2.89~9.49), hemorrhagic stroke3.70(95%CI:3.64~3.77), infection 3.67 (95%CI:2.19~6.16), stroke severity 1.23 (95%CI:1.06~1.42), and age 1.07 (95%CI:1.02~1.13) resepetively. Publish bias existed in anterior circulation infarction. Conclusion Vision deficits, increased C-reactive protein, cognitive decline, hemorrhagic stroke, infection, stroke severity and age are risk factors for PSD. Evidences are not sufficient for the impact of anterior circulation infarction on PSD. Early intervention for these modifiable risk factors is recommended.

Key words: stroke, delirium, risk factor, systematic review, Meta-analysis

CLC Number: 

  • R248.2
[1] Carin-Levy G, Mead G E, Nicol K, et al.Delirium in Acute Stroke: Screening Tools, Incidence Rates and Predictors: A Systematic Review[J]. J Neurol, 2012,259(8):1590-1599.DOI:10.1007/s00415-011-6383-4.
[2] Miu D K Y, Yeung J C Y. Incidence of Post-stroke Delirium and 1-year Outcome[J]. Geriatr Gerontol Int, 2013, 13(1):123-129.DOI:10.1111/j.1447-0594.2012.00871.x.
[3] Shi Q, Presutti R, Selchen D, et al.Delirium in Acute Stroke: A Systematic Review and Meta-analysis[J]. Stroke, 2012, 43(3):645-649.DOI:10.1161/STROKEAHA.111.643726.
[4] Ojagbemi A, Ffytche D H.Are Stroke Survivors with Deliri-um at Higher Risk of Post-stroke Dementia? Current Evidence and Future Directions[J]. Int J Geriatr Psych, 2016, 31(12):1289-1294.DOI:10.1002/gps.4506.
[5] 朱读伟,严谨. 护士识别谵妄的现状及研究进展[J]. 护理学报, 2016,23(20):23-27.DOI:10.16460/j.issn1008-9969.2016.20.023.
[6] 熊小平,张艳芳,石远,等. 急性脑卒中患者伴发谵妄的相关因素分析[J]. 中国临床保健杂志, 2017(5):519-521.DOI:10.3969/J.issn.1672-6790.2017.05.011.
[7] Oldenbeuving A W, de Kort P L, Jansen B P, et al. Delirium in the Acute Phase after Stroke: Incidence, Risk Factors, and Outcome[J]. Neurology, 2011, 76(11):993-999.DOI:10.1212/WNL.0b013e318210411f.
[8] Ojagbemi A, Owolabi M, Bello T, et al.Stroke Severity Predicts Poststroke Delirium and Its Association with Dementia: Longitudinal Observation from a Low Income Setting[J]. J Neurol SCI, 2017, 375:376-381.DOI:10.1016/j.jns.2017.02.039.
[9] Carin-Levy G, Mead G E, Nicol K,et al.Delirium in Acute Stroke: Screening Tools, Incidence Rates and Predictors: A Systematic Review[J]. Journal of Neurology, 2012, 259(8): 1590-1599.DOI:10.1007/s00415-011-6383-4.
[10] Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non-randomised Studies in Meta-analyses[EB/OL].(2018-02-26)[2018-03-18].http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
[11] Caeiro L, Ferro J M, Albuquerque R,et al.Delirium in the First Days of Acute Stroke[J]. J Neurol, 2004, 251(2): 171-178.DOI:10.1007/s00415-004-0294-6.
[12] Sheng A Z, Shen Q, Cordato D, et al.Delirium within Three Days of Stroke in a Cohort of Elderly Patients[J]. J Ameriatr Soc, 2006, 54(8):1192-1198.DOI:10.1111/j.1532-5415.2006.00806.x.
[13] Mcmanus J, Pathansali R, Hassan H, et al.The Course of Delirium in Acute Stroke[J]. Age Ageing,2009,38(4): 385-389.DOI:10.1093/ageing/afp038.
[14] Dahl M H, Rønning O M, Thommessen B.Delirium in Acute Stroke-prevalence and Risk Factors[J]. Acta Neurol Scand, 2010,122(190):39.DOI:10.1111/j.1600-0404.2010.01374.
[15] Kostalova M, Bednarik J, Mitasova A,et al.Towards a Predictive Model for Post-stroke Delirium[J]. Brain Injury, 2012,26(7-8):962-971.DOI:10.3109/02699052.2012.660510.
[16] Miu D K Y, Yeung J C Y. Incidence of Post-stroke Delirium and 1-year Outcome[J]. Geriatr Gerontol Int, 2013,13(1):123-129.DOI:10.1111/j.1447-0594.2012.00871.x
[17] Alvarez-Perez F J, Paiva F. Prevalence and Risk Factors for Delirium in Acute Stroke Patients. A Retrospective 5-Years Clinical Series[J]. J Stroke Cerebrovasc, 2017,26(3):567-573.DOI:10.1016/j.jstrokecerebrovasdis.2016.11.120.
[18] Lim T S, Lee J S, Yoon J H, et al.Cigarette Smoking is an Independent Risk Factor for Post-stroke Delirium[J]. BMC Neurol, 2017, 17(1):56.DOI:10.1186/s12883-017-0840-3.
[19] Nydahl P, Bartoszek G, Binder A, et al.Prevalence for Delirium in Stroke Patients: A Prospective Controlled Study[J].Brain Behav,2017,7(8):e748.DOI:10.1002/brb3.748.
[20] Pasinska P, Kowalska K, Klimiec E, et al.Frequency and Predictors of Post-stroke Delirium in Prospective Observational Polish Study (PROPOLIS)[J]. J Neurol, 2018.DOI:10.1007/s00415-018-8782-2.
[21] 殷晓山,金扬,翁建龙. 脑梗死后谵妄患者的危险因素及随访认知和功能状态的改变[J]. 浙江实用医学, 2012, 17(4):245-247.DOI:10.3969/j.issn.1007-3299.2012.04.004.
[22] 屈剑锋,陈仰昆,罗根培,等. 缺血性脑卒中后谵妄的临床及影像学相关因素研究[J]. 广东医学, 2018,39(2):212-215.DOI:10.13820/j.cnki.gdyx.20180130.005.
[23] Barr J, Fraser G L, Puntillo K, et al.Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit[J]. Crit Care Med, 2013, 41(1):263-306.DOI:10.1097/CCM.0b013e3182783b72.
[24] Van Gool W A,Van D B D,Eikelenboom P. Systemic Infection and Delirium: When Cytokines and Acetylcholine Collide[J]. Lancet, 2010, 375(9716):773-775.DOI:10.1016/S0140-6736(09)61158-2.
[25] 杨进玉. 急性卒中后谵妄的临床特点[J]. 临床神经病学杂志, 2012, 25(4):253.
[26] 朱读伟,严谨. 国外老年谵妄护理管理现状[J]. 中国护理管理, 2017,17(6):796-799.DOI:10.3969/j.issn.1672-1756.2017.06.016.
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