| dc.description.abstract | Delirium is a distressing and common condition among patients in the intensive care unit (ICU), with known associations with poor long-term outcomes in select patient populations. Little is known about this condition after acute stroke, particularly in those with subarachnoid hemorrhage. This descriptive study evaluated the associations of delirium in the ICU with cognitive, functional, mental health, and quality of life outcomes among patients who experienced nontraumatic subarachnoid hemorrhage. Seventy-five patients from a single academic medical center consented to participate in this study. Delirium screenings and pre-determined covariates were prospectively collected in the ICU. Outcomes were collected by phone at 90-days post-hemorrhage. Nonparametric regression analyses were used to evaluate the strength and direction of having delirium and the additive effect of delirium duration with each outcome measure. Of the 75 participants enrolled in the study, 44 participants (58.7%) experienced delirium in the ICU. Median delirium duration was 1.0 [IQR 0.0, 5.0] day. Ninety-day self-reported outcomes were completed for 47 (62.7%) participants. An additional 14 (18.7%) were only able to provide functional outcomes. Those who experienced delirium in the ICU demonstrated worse cognitive outcome at 90 days than those who never experienced delirium, although this effect was no longer significant after controlling for those covariates that significantly correlated with 90-day cognitive scores. To the contrary, those with delirium in the ICU experienced significantly worse functional outcome on three separate measures. This effect remained significant for modified rankin scale scores (i.e, global disability) even after controlling for each critical covariate, although the additive effect of delirium duration was not significant. The effect of delirium on instrumental activities of daily living scores was considerably stronger than the effect on basic activities of daily living. After controlling for the effect of having delirium, the expected mean difference in instrumental activities of daily living scores for each cumulative day of delirium was also statistically significant. Having delirium in the ICU did not demonstrate a significant effect on depression, post-traumatic stress, or quality of life scores. | |
