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Journal of the Korean Academy of Rehabilitation Medicine 2010;34(4):403-408.
Influence of Delirium on Functional Recovery in Acute Stroke.
Kim, Se Won , Kim, Bo Ram , Lim, Jeong Hoon , Koh, Seong Eun , Lee, In Sik , Kim, Jong Moon , Kim, Hahn Young , Lee, Jongmin
1Department of Rehabilitation Medicine, Konkuk University School of Medicine, Korea. leej@kuh.ac.kr
2Department of Neurology, Konkuk University School of Medicine, Korea.
급성기 뇌졸중에서 섬망이 기능 회복에 미치는 영향
김세원, 김보람, 임정훈, 고성은, 이인식, 김종문, 김한영1, 이종민
건국대학교 의학전문대학원 재활의학교실, 1신경과학교실
Abstract
Objective
To investigate the risk factors for poststroke delirium and evaluate its influence on functional recovery after ischemic stroke.
Method
Risk factors for delirium were investigated retrospectively in three hundred twenty nine acute ischemic stroke patients over 60 years of age. Among the 329 patients, sixty seven developed delirium. Data were analyzed between delirium group (n=22) and control group (n=22) according to age, sex, lesion location and clinical features. Korean modified Barthel index (K-MBI), Korean National Institutes of Health stroke scale (K-NIHSS) and Korean mini-mental state examination (KMMSE) were measured at second and sixth weeks after onset and compared for both groups.
Results
Parameters showing statistically significant difference between two groups were age over 80, hyponatremia, sleep deprivation, cognitive impairment and cardiogenic embolism. There was no significant difference in K-MBI, K-NIHSS and K-MMSE scores at second week between the two groups. The delirium group showed significantly less improvement in K-MBI and K-NIHSS scores compared to control group (9.5±10.2 vs 18.5±11.6, p=0.011; −0.7±1.2 vs −1.8±1.3, p=0.014). There was no significant improvement in K-MMSE score.
Conclusion
The possible risk factors for delirium in acute ischemic stroke are age over 80, hyponatremia, sleep deprivation, cognitive impairment and cardiogenic embolism. Stroke patients with comorbid delirium showed poorer functional outcome. Delirium seems to have detrimental effect in functional recovery after stroke. (J Korean Acad Rehab Med 2010; 34: 403-408)
Key Words: Stroke, Delirium, Prognosis


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