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PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS): methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools.

Klimiec E, Dziedzic T, Kowalska K, Szyper A, Pera J, Potoczek P, Slowik A, Klimkowicz-Mrowiec A - BMC Neurol (2015)

Bottom Line: We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset.Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke.This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Jagiellonian University Medical College, Botaniczna 3, 31-503, Krakow, Poland. eklimiec@gmail.com.

ABSTRACT

Background: Between 10 % to 48 % of patients develop delirium in acute phase of stroke. Delirium determinants and its association with other neuropsychiatric disturbances in stroke are poorly understood. The wildly accepted predictive model of post-stroke delirium is still lacking.

Methods/design: This is a prospective, observational, single-center study in patients with acute phase of stroke. We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset. The goals of the study are: 1) to determine frequency of delirium and subsyndromal delirium in Polish stroke patients within 7 days after admission to the hospital; 2) to determine factors associated with incidence, severity and duration of delirium and subsyndromal delirium and to create a predictive model for post-stroke delirium; 3) to determine the association between delirium and its cognitive, psychiatric, behavioral and functional short and long-term consequences; 4) to validate scales used for delirium diagnosis in stroke population. Patients will be screened for delirium on daily basis. The diagnosis of delirium will be based on DSM-V criteria. Abbreviated version of Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit will be used for delirium and sub-delirium screening. Severity of delirium symptoms will be assessed by Delirium Rating Scale Revised 98 and Cognitive Test for Delirium. Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke.

Discussion: This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences. Collected information allow us to create a predictive model for post-stroke delirium.

No MeSH data available.


Related in: MedlinePlus

Flowchart for the study procedures. AES–Apathy Evaluation Scale, bCAM–Abbreviated version of Confusion Assessment Method, BDI–The Buss-Durke Inventory, CAM-ICU–Intensive Care Units Version of Confusion Assessment Method, CTD–Cognitive Test for Delirium, DMC–Delirium Motor Checklist, DMSS-4–Delirium Motor Subtype Scale 4, DRS-R-98–Delirium Rating Scale Revised 98, DSM-V–The Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders, IADL–Instrumental Activities of Daily Living, IQCODE–Informant Questionnaire on Cognitive Decline in the Elderly, MoCA–Montreal Cognitive Assessment, mRS–modified Rankin Scale, Neuropsychological examination–described in the text, NPI–Neuropsychiatric Inventory, PHQ-9–Patient Health Questionnaire, Predisposing Factors Assessment–described in the Table 2., STAI–State Trait Anxiety Inventory, T-MoCA–telephone version of Montreal Cognitive Assessment
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Fig1: Flowchart for the study procedures. AES–Apathy Evaluation Scale, bCAM–Abbreviated version of Confusion Assessment Method, BDI–The Buss-Durke Inventory, CAM-ICU–Intensive Care Units Version of Confusion Assessment Method, CTD–Cognitive Test for Delirium, DMC–Delirium Motor Checklist, DMSS-4–Delirium Motor Subtype Scale 4, DRS-R-98–Delirium Rating Scale Revised 98, DSM-V–The Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders, IADL–Instrumental Activities of Daily Living, IQCODE–Informant Questionnaire on Cognitive Decline in the Elderly, MoCA–Montreal Cognitive Assessment, mRS–modified Rankin Scale, Neuropsychological examination–described in the text, NPI–Neuropsychiatric Inventory, PHQ-9–Patient Health Questionnaire, Predisposing Factors Assessment–described in the Table 2., STAI–State Trait Anxiety Inventory, T-MoCA–telephone version of Montreal Cognitive Assessment

Mentions: For those patients who are not able to undergo the telephone interview only the care-giver will be interview according to the same procedure as described above. Study plan flow chart is shown in Fig. 1.Fig. 1


PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS): methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools.

Klimiec E, Dziedzic T, Kowalska K, Szyper A, Pera J, Potoczek P, Slowik A, Klimkowicz-Mrowiec A - BMC Neurol (2015)

Flowchart for the study procedures. AES–Apathy Evaluation Scale, bCAM–Abbreviated version of Confusion Assessment Method, BDI–The Buss-Durke Inventory, CAM-ICU–Intensive Care Units Version of Confusion Assessment Method, CTD–Cognitive Test for Delirium, DMC–Delirium Motor Checklist, DMSS-4–Delirium Motor Subtype Scale 4, DRS-R-98–Delirium Rating Scale Revised 98, DSM-V–The Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders, IADL–Instrumental Activities of Daily Living, IQCODE–Informant Questionnaire on Cognitive Decline in the Elderly, MoCA–Montreal Cognitive Assessment, mRS–modified Rankin Scale, Neuropsychological examination–described in the text, NPI–Neuropsychiatric Inventory, PHQ-9–Patient Health Questionnaire, Predisposing Factors Assessment–described in the Table 2., STAI–State Trait Anxiety Inventory, T-MoCA–telephone version of Montreal Cognitive Assessment
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4472262&req=5

Fig1: Flowchart for the study procedures. AES–Apathy Evaluation Scale, bCAM–Abbreviated version of Confusion Assessment Method, BDI–The Buss-Durke Inventory, CAM-ICU–Intensive Care Units Version of Confusion Assessment Method, CTD–Cognitive Test for Delirium, DMC–Delirium Motor Checklist, DMSS-4–Delirium Motor Subtype Scale 4, DRS-R-98–Delirium Rating Scale Revised 98, DSM-V–The Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders, IADL–Instrumental Activities of Daily Living, IQCODE–Informant Questionnaire on Cognitive Decline in the Elderly, MoCA–Montreal Cognitive Assessment, mRS–modified Rankin Scale, Neuropsychological examination–described in the text, NPI–Neuropsychiatric Inventory, PHQ-9–Patient Health Questionnaire, Predisposing Factors Assessment–described in the Table 2., STAI–State Trait Anxiety Inventory, T-MoCA–telephone version of Montreal Cognitive Assessment
Mentions: For those patients who are not able to undergo the telephone interview only the care-giver will be interview according to the same procedure as described above. Study plan flow chart is shown in Fig. 1.Fig. 1

Bottom Line: We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset.Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke.This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Jagiellonian University Medical College, Botaniczna 3, 31-503, Krakow, Poland. eklimiec@gmail.com.

ABSTRACT

Background: Between 10 % to 48 % of patients develop delirium in acute phase of stroke. Delirium determinants and its association with other neuropsychiatric disturbances in stroke are poorly understood. The wildly accepted predictive model of post-stroke delirium is still lacking.

Methods/design: This is a prospective, observational, single-center study in patients with acute phase of stroke. We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset. The goals of the study are: 1) to determine frequency of delirium and subsyndromal delirium in Polish stroke patients within 7 days after admission to the hospital; 2) to determine factors associated with incidence, severity and duration of delirium and subsyndromal delirium and to create a predictive model for post-stroke delirium; 3) to determine the association between delirium and its cognitive, psychiatric, behavioral and functional short and long-term consequences; 4) to validate scales used for delirium diagnosis in stroke population. Patients will be screened for delirium on daily basis. The diagnosis of delirium will be based on DSM-V criteria. Abbreviated version of Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit will be used for delirium and sub-delirium screening. Severity of delirium symptoms will be assessed by Delirium Rating Scale Revised 98 and Cognitive Test for Delirium. Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke.

Discussion: This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences. Collected information allow us to create a predictive model for post-stroke delirium.

No MeSH data available.


Related in: MedlinePlus