Agitation, Delirium, and Cognitive Outcomes in Intracerebral Hemorrhage

Overview

Journal Psychosomatics

Publisher Elsevier

Specialty Psychiatry

Date 2016 Sep 27

PMID 27665997

Citations 14

Authors

Lisa J Rosenthal

Brandon A Francis

Jennifer L Beaumont

David Cella

Michael D Berman

Matthew B Maas

Eric M Liotta

Robert Askew

Andrew M Naidech

Affiliations

Soon will be listed here.

Abstract

Background: Delirium predicts higher long-term cognitive morbidity. We previously identified a cohort of patients with spontaneous intracerebral hemorrhage and delirium and found worse outcomes in health-related quality of life (HRQoL) in the domain of cognitive function.

Objective: We tested the hypothesis that agitation would have additional prognostic significance on later cognitive function HRQoL.

Methods: Prospective identification of 174 patients with acute intracerebral hemorrhage, measuring stroke severity, agitation, and delirium, with a standardized protocol and measures. HRQoL was assessed using the Neuro-QOL at 28 days, 3 months, and 1 year. Functional outcomes were measured with the modified Rankin Scale.

Results: Among the 81 patients with HRQoL follow-up data available, patients who had agitation and delirium had worse cognitive function HRQoL scores at 28 days (T scores for delirium with agitation 20.9 ± 7.3, delirium without agitation 30.4 ± 16.5, agitation without delirium 36.6 ± 17.5, and neither agitated nor delirious 40.3 ± 15.9; p = 0.03) and at 1 year (p = 0.006). The effect persisted in mixed models after correction for severity of neurologic injury, age, and time of assessment (p = 0.0006) and was not associated with medication use, seizures, or infection.

Conclusions: The presence of agitation with delirium in patients with intracerebral hemorrhage may predict higher risk of unfavorable cognitive outcomes up to 1 year later.

Citing Articles

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Duggan M, Van J, Ely E Crit Care Clin. 2020; 37(1):175-190.

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