Abstract Details

In-hospital Delirium and Long-Term Cognitive Outcomes among Patients with Intracerebral Hemorrhage: A population-based cohort analysis
Cerebrovascular Disease and Interventional Neurology
S15 - Intracerebral Hemorrhage and SAH (2:28 PM-2:39 PM)
009

Little is known regarding the association between acute in-hospital exposures such as delirium and long-term cognitive outcomes in patients with ICH.

 

To explore the risk of mild cognitive impairment or dementia (MCID) among intracerebral hemorrhage (ICH) patients who experienced in-hospital delirium.

 

We utilized State Inpatient and Emergency Department Databases for NY (2006 – 2014), CA (2005 – 2011), and FL (2005 – 2014), and established a cohort by selecting MCID-free patients with a primary diagnosis of ICH (ICD-9: 431) during a 2yr period. Patients with concurrent diagnoses of head trauma, arteriovenous malformation or missing linkage information were excluded. Delirium during the initial ICH event was tagged using a validated algorithm with high specificity for the confusion assessment method. The cohort was followed for MCID diagnoses. Patients that died within 90 days of ICH were excluded. We conducted time-to-event analyses and report cumulative incidence, 95% confidence interval (CI) and hazard ratios (HR) for risk of MCID among ICH patients with and without delirium.

 

A total of 18,083 ICH patients (age: 67.2, female: 47.6%, white: 59.1%) were included and were followed for up to 8yrs, resulting in 42,100 person-years. Patients who experienced delirium had a significantly higher comorbidity index and intensity of in-hospital treatment. Cumulative incidence (95% CI) for development of MCID was significantly higher among delirium patients (6.07, 5.05 – 7.30) as compared to non-delirium patients (4.07, 3.87 – 4.27). Likewise, risk of MCID among delirium patients was significant higher in the fully adjusted Cox proportional hazard model (HR, 95% CI: 1.42, 1.17 – 1.73).

 

ICH patients with in-hospital delirium are at a significantly higher risk of developing MCID over time. Further investigation is warranted to understand the biological mechanism for cognitive decline among ICH patients who experience in-hospital delirium.
Authors/Disclosures
Jennifer Meeks
PRESENTER
No disclosure on file
No disclosure on file
Katie Alex (University of Texas Health Science Center At Houston) No disclosure on file
No disclosure on file
Sunil Sheth, MD (University of Texas At Houston) Dr. Sheth has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Penumbra. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Imperative Care.
Farhaan S. Vahidy, MBBS, PhD (Houston Methodist) Dr. Vahidy has nothing to disclose.