Global prevalence and risk factors of delirium among patients following acute stroke: A systematic review and meta-analysis.

Abstract

Background and objective: The exact prevalence and risk factors of delirium following stroke at an acute stage remains unclear. We aimed to determine the global prevalence and risk factors of delirium following acute stroke.

Method: Observational studies reporting the prevalence of or risk factors for delirium following acute stroke published in the PubMed, Embase, and Scopus databases before April 16, 2024, were identified. Data were extracted by two independent reviewers. A random effects model was used for data analysis.

Results: Our meta-analysis included 48 studies on prevalence and 25 studies on risk factors for poststroke delirium. The pooled global prevalence rate of delirium was 24 % (18 %-30 %). Hemorrhagic stroke type, early assessment (within 3 days of stroke onset), older age, and male sex were risk factors for poststroke delirium. Independent factors significantly associated with poststroke delirium (all p < 0.05) were age, dementia, prior stroke, prior total anterior circulation infarct stroke subtype, atrial fibrillation, elevated C-reactive protein levels, aphasia, poor vision, neglect, depression, and the use of urinary catheters and gastric tubes.

Conclusion: Approximately a quarter of the included patients with acute stroke experienced delirium. Our findings regarding the risk factors for poststroke delirium can provide an evidence-based approach for future strategies to prevent delirium.

Fundings: NSTC, Taiwan (MOST 113-2628-B- 038-00-MY3 and 111-2314-B-038-033-MY3).

Protocol: The International Prospective Register of Systematic Reviews (CRD42024518119).