Associations Between Stroke Localization and Delirium: A Systematic Review and Meta-Analysis.
Delirium
Localization
Meta-analysis
Stroke
Systematic review
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
26
10
2021
revised:
23
11
2021
accepted:
04
12
2021
pubmed:
27
12
2021
medline:
9
3
2022
entrez:
26
12
2021
Statut:
ppublish
Résumé
Delirium is common among patients with acute stroke and associated with worse outcomes. However, it is unclear which stroke locations or types are most associated with delirium. We systematically reviewed studies of patients with acute stroke that reported stroke locations and types by delirium status. We included papers in any language, through a combined search from January 2010 to June 2021. Case studies with less than 20 patients, case-control studies, and randomized controlled trials were excluded. MEDLINE, EMBASE, PsycINFO, CINAHL, and Alois databases were searched. Pooled relative risks were calculated using bivariate random effects models or network meta-analysis. Methodological quality was assessed across 8 factors. 31 patient samples representing 8329 patients were included. Delirium was more common in patients with supratentorial lesions than infratentorial (RR [Relative Risk] 2.01, CI [Confidence Interval] 1.49-2.72); anterior circulation lesions than posterior (RR 1.41, CI 1.13-1.78); and cortical lesions than subcortical (RR 1.54, CI 1.25-1.89). Stroke side was not associated with delirium (right vs. left: RR 0.99, CI 0.77-1.28). Delirium was more common in patients with hemorrhagic strokes than ischemic (RR 1.74, CI 1.42-2.11) and patients with preexisting qualitative atrophy (RR 1.66, CI 1.21-2.27). Several brain localizations and types of strokes were associated with delirium. Conclusions were in part limited by the heterogeneity of studies and broad or qualitative lesion descriptions. These results may assist in anticipating the risk of delirium in acute stroke and highlight brain networks and pathologies that may be involved in the pathophysiology of delirium.
Identifiants
pubmed: 34954599
pii: S1052-3057(21)00675-3
doi: 10.1016/j.jstrokecerebrovasdis.2021.106270
pmc: PMC8837688
mid: NIHMS1765051
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
106270Subventions
Organisme : NINDS NIH HHS
ID : R01 NS082285
Pays : United States
Organisme : NIMH NIH HHS
ID : K08 MH116135
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH113929
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS086905
Pays : United States
Organisme : NINDS NIH HHS
ID : U19 NS115388
Pays : United States
Organisme : NIMH NIH HHS
ID : R21 MH126271
Pays : United States
Organisme : NIA NIH HHS
ID : R56 AG069086
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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