4.5 Article

Five-year stroke prognosis. Influence of post-stroke delirium and post-stroke dementia on mortality and disability (Research Study - Part of the PROPOLIS Study)

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NEUROLOGICAL SCIENCES
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SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-023-07129-5

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Stroke; Mortality; Delirium; Cognition disorders; Dementia

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This study aimed to evaluate the five-year mortality rate of stroke patients and assess the impact of post-stroke delirium and post-stroke dementia on mortality and disability. The study found that over half of stroke patients die within five years, and post-stroke delirium and post-stroke dementia are associated with an increased risk of death and disability.
IntroductionWith increasing life expectancy and the rising incidence of stroke in young adults, it is important to know the long-term prognosis of this condition. Post-stroke delirium and post-stroke dementia are common complications of stroke that negatively affect prognosis. The purpose of this study was to evaluate five-year mortality from stroke and to assess the influence of post-stroke delirium and post-stroke dementia on mortality and disability over the five-year period.MethodsConsecutive patients admitted to the stroke unit for acute stroke or transient ischemic attacks were screened for in-hospital delirium. At the three- and twelve-month follow-up, the same patients underwent neurocognitive testing. Diagnoses of in-hospital delirium and dementia after three and twelve months based on DSM-5 criteria. Five years after stroke surviving patients were reevaluated. Outcome assessment included place of stay, current functional status assessed by the modified Rankin Scale (mRS), or death.ResultsAt the five-years of follow-up, data were collected from 575 of 750 patients originally included in the study (76.67%). The mortality rate was 51.65%. In-hospital post-stroke delirium and post-stroke dementia diagnosed three and twelve months after stroke were independent risk factors for death and an increase in mRS score of >= 1 or >= 2 points. There was no significant association with institutionalization rate.ConclusionsMore than half of post-stroke patients die within five years of follow-up. Post-stroke delirium and post-stroke dementia are associated with an increased risk of death and disability.

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