Poststroke Delirium Clinical Motor Subtypes: The PRospective Observational POLIsh Study (PROPOLIS)

Area of Science:

• Neurology
• Geriatrics
• Psychiatry

Background:

• Delirium is a frequent neurobehavioral complication following stroke.
• Motor subtypes of delirium (hypoactive, hyperactive, mixed) are not well understood.
• Subtype recognition impacts delirium diagnosis and patient outcomes.

Purpose of the Study:

• To determine the frequency of poststroke delirium motor subtypes.
• To identify predictors for different delirium motor subtypes.
• To develop predictive models for poststroke delirium subtypes.

Main Methods:

• Prospective study of consecutive stroke patients.
• Delirium screening using the Confusion Assessment Method for the Intensive Care Unit.
• Delirium diagnosis via DSM-5 criteria and subtype classification using the Delirium Motor Subtype Scale-4.
• Assessment of demographic, clinical, and cognitive factors.

Main Results:

• 27.07% of stroke patients developed delirium (n=203/750).
• Hypoactive delirium was most common (11.34%), followed by mixed (10.27%) and hyperactive (4.13%).
• Cognitive impairment at admission and spatial neglect were key predictors for all motor subtypes.

Conclusions:

• Screening for poststroke delirium is crucial.
• The hypoactive subtype has the poorest prognosis and is often misdiagnosed.
• Identified predictors are routinely assessed, aiding early risk identification for specific delirium subtypes.