| Popis: |
Delirium, an acute and fluctuating decline in cognitive functioning, increases mortality, length of hospital stays, and adversely affects functional outcomes. Previous studies suggested that the incidence of delirium may be increased in right-hemisphere strokes. Similarly, spatial neglect, a disabling deficit in unilateral spatial processing, is more common and more severe following a right-sided stroke. Spatial neglect has been established as a risk factor for delirium. We hypothesized that functionally relevant spatial neglect and delirium are associated in right-hemisphere stroke patients during acute inpatient rehabilitation. We examined data from consecutive unilateral stroke patients evaluated with the 3-minute diagnostic interview for confusion assessment method (3D-CAM) and the Catherine Bergego Scale (CBS) via the Kessler Foundation Neglect Assessment Process (KF-NAP).This is a retrospective, cohort study.Data collected in an acute inpatient rehabilitation facility.626 stroke patients were included.The measures were the relative risk of right-hemisphere stroke patients having delirium when also positive for spatial neglect compared to right-hemisphere stroke patients without spatial neglect, the incidence of 3D-CAM positive results by stroke hemisphere, and the impact of spatial neglect and delirium on functional outcomes for right-brain stroke patients.There was a significantly higher risk of delirium in right-hemisphere stroke patients with spatial neglect compared to right-hemisphere stroke patients without spatial neglect. The rates of 3D-CAM positive results were not statistically different for left- compared to right-hemisphere strokes. Both delirium and spatial neglect had significant adverse effects on right-hemisphere stroke patients' functional independence.The results demonstrate an association between spatial neglect and delirium in right hemisphere stroke patients in the acute inpatient rehabilitation setting. Due to the negative impact of these impairments on functional outcomes after stroke, prevention, early detection, and targeted treatments should be prioritized for these patients. |
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