Abstract Details

This study aimed at identifying the incidence, predictors and impact on long-term mortality and dementia of early-onset delirium in a cohort of patients with spontaneous intracerebral hemorrhage (ICH).

We prospectively recruited consecutive patients in the Prognosis of InTra-Cerebral Hemorrhage (PITCH) cohort and analyzed incidence rate of early-onset delirium (i.e. during the first 7-days after ICH onset) with a competing risk model. We used a multivariable Fine-Gray model to identify baseline predictors, a Cox regression model to study its impact on the long-term mortality risk and a Fine-Gray model adjusted for pre-specified confounders to analyze its impact on new-onset dementia.

The study population consisted of 248 patients (mean age 70 years, 54% males). Early-onset delirium incidence rate was 29.8% (95% confidence interval [CI] 24.3-35.6). Multivariate analysis showed that pre-existing dementia (subhazard ratio [SHR] 2.08, 95%CI 1.32–3.32, p=0.002), heavy alcohol intake (SHR 1.79, 95%CI 1.13–2.82, p=0.013) and ICH lobar location (SHR 1.56, CI 1.01–2.42, p=0.049) independently predicted early-onset delirium. Median follow-up was 9.5 years. Early-onset delirium was associated with higher mortality rates during the first 5-years of follow-up (HR 1.52, 95%CI 1.00–2.31, p=0.049), but did not predict new-onset dementia (SHR 1.31, 95%CI 0.60–2.87).

Early-onset delirium is a frequent complication after ICH, it is associated with markers of pre-existing brain vulnerability and with higher mortality risk, but not with higher dementia rates during long-term follow-up.