A multicenter prospective study on the prevalence of Post Stroke Delirium and associated risk factors in Addis Ababa, Ethiopia.

Abstract

Background: Post-stroke delirium, a frequent and significant complication of stroke, manifests as a sudden onset of confusion, altered consciousness, and cognitive decline. Various factors contribute to its occurrence, including old age, multiple comorbidity, electrolyte abnormalities, and infections. The impact of post-stroke delirium on stroke recovery is substantial. It leads to prolonged hospital stays, heightened risk of institutionalization, increased dependence, and elevated mortality rates. As a result, early identification and prompt treatment of post-stroke delirium are imperative for optimizing outcomes in stroke patients.

Objective: The objective of this study is to determine the Prevalence of post-stroke delirium and associated risk factors in hospitalized patients at TASH, Y12HMC, and YSC, Addis Ababa, Ethiopia from August to December 2023.

Method: We performed a prospective observational study, including all the stroke patients admitted to the respective study areas during the study period from August to December 2023. Participants who fulfilled the inclusion criteria were involved in this study. Data was collected using an interviewer-administered Questionnaire with a well-tested and validated tool, Patients were assessed for Delirium within 48 h of admission and subsequently screened every 12 h. Descriptive statistics was used to summarize the data in terms of frequency, proportion, mean, and standard deviation. Bivariate and multivariate logistic regression analyses were carried out to identify associated factors. Statistical significance was considered when the p-value was below 0.05.

Results: Out of 101 patients 26(25.7%) had Post-Stroke Delirium. The majority 56 (55.4%) of the patients were females. The mean (SD) age of the study participants was 56.05 ± 15.38 years, and the mean time in days until the occurrence of delirium was 3 ± 1 days. Multivariable logistic regression analysis showed that, Age Greater than 60(AOR = 19.1, 95% CI (1.7-211) p = 0.016, Presence of Sepsis (AOR = 8.3, 95% CI (1.2-56) P = 0.029, Presence of Polypharmacy (AOR = 157, 95% CI (10.2-244) P = 0.0001, Presence of Electrolyte Derangement (AOR = 65.2, 95% CI (3.4-124.1) P = 0.005 were statistically significant risk factors.

Conclusion: Our Study showed that Post Stroke Delirium occurs in a quarter of patients admitted with a Diagnosis of Acute Stroke, and the Identified risk factors were Age greater than 60, Polypharmacy, Presence of Sepsis and Electrolyte Derangement. Medical professionals responsible for caring for acute stroke patients should be vigilant in identifying those at higher risk of developing post-stroke delirium. Additionally, they should focus on preventing and treating possible precipitating factors such as infections or electrolyte abnormalities. Incorporating delirium screening into routine patient assessments is crucial.