Abstract Details

Title Acute Ischemic Stroke Patients Receiving Reperfusion Therapy Do Not Have Worse 90-day Outcomes After Delirium

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-001

Background PSD is associated with increased mortality and worse long-term functional outcomes. Patients who receive reperfusion therapies in the hospital are frequently kept from regular sleep-wake cycles the first 24 hours after treatment, and this disruption could lead to an increase in PSD.

Objective Evaluate the effect of post-stroke delirium (PSD) on immediate and long-term outcomes in AIS patients receiving reperfusion therapies.

Design/Methods Between September 2019 and June 2021, patients diagnosed with AIS within 48 hours of stroke onset were prospectively evaluated for PSD using the Confusion Assessment Method (CAM)-ICU daily for the first eight days of their hospital stay. Patients with severe stroke and expected mortality within the first month at the time of admission or with severe aphasia unable to follow commands were excluded. Reperfusion therapies were defined as any IV thrombolytic, or mechanical thrombectomy (MT). The primary outcome was considered a 90-day mRS score of 0-2.

Results Of 179 patients assessed with the CAM-ICU, 89 (49.7%) had PSD. We identified 94 patients that had undergone one or both reperfusion therapies; 52 (55.3%) had delirium. Patients who received tPa had a higher risk for delirium (42 vs 29, p = 0.04), but no difference was observed with MT. Patients with PSD had a longer hospital length of stay and a higher admission NIHSS. Patients with delirium who received tPA were more likely to be discharged to inpatient rehabilitation facilities than home (p-value 0.004, OR 10.1 95%CI 2.1,48). No significant difference was found in 90-day modified ranking scale (mRS) scores of 0-2 in those with or without PSD (14 vs 12, p=0.62).

Conclusions AIS patients with PSD after reperfusion therapy had no significant difference in 90-day good outcomes despite having longer hospital admissions and being less likely to be discharged home. Further evaluation into how reperfusion therapies convey protection to patients is necessary.

Authors/Disclosures
Mohammad Jamil Ahmad, MD (University of Pittsburgh medical Center) PRESENTER	Dr. Ahmad has nothing to disclose.
Sahar S. Anjum, MS (UTHealth)	Miss Anjum has nothing to disclose.
Aditya Kumar, MD (University of Texas Health Science Center)	Dr. Kumar has nothing to disclose.
	No disclosure on file
	No disclosure on file
Bethany Williams, PhD (UTHealth At Houston)	Dr. Williams has received research support from UTHealth at Houston.
Alicia Zha, MD (The Ohio State University Wexner Medical Center)	Dr. Zha has nothing to disclose.