Predicting delirium in acute ischemic stroke: the PREDELIS score

Area of Science:

• Neurology
• Geriatrics
• Critical Care Medicine

Background:

• Delirium is a frequent complication of acute ischemic stroke.
• It is associated with poor functional outcomes post-stroke.
• Current prevention strategies are challenging to implement in unselected stroke patients.

Purpose of the Study:

• To develop and validate a risk score for predicting delirium in acute ischemic stroke patients.
• The score aims to facilitate early identification of high-risk individuals.
• This facilitates targeted screening and preventive interventions.

Main Methods:

• Retrospective analysis of 14,475 ischemic stroke patients from Austrian stroke units (2013-2021).
• Data extracted from a comprehensive medical information system.
• Multivariable logistic regression used to identify delirium predictors for the PREDELIS score.

Main Results:

• The PREDELIS score incorporates factors like previous delirium, alcohol consumption, age, sex, infection, stroke severity, stroke type, and sensory impairment.
• The score demonstrated good predictive performance with an AUC of 0.72 in both derivation and validation cohorts.
• Patients with a PREDELIS score ≤5 had a low delirium risk (2.5%), while those with a score ≥9 faced a high risk (30.9%).

Conclusions:

• The PREDELIS score offers a novel tool for early delirium risk stratification in acute ischemic stroke.
• It enables clinicians to identify patients at high risk for delirium.
• Facilitates targeted screening and preventative measures to improve patient outcomes.