Delirium Common for ICU Patients After Stroke

Study in American Journal of Critical Care from researchers at The Ohio State University Wexner Medical Center found delirium affected 44% of patients who were critically ill after a stroke

Male medical figure with front of the brain highlighted

Having had delirium, even for a single day, was associated with more days receiving mechanical ventilation, longer length of stay, lower likelihood of discharge to home.kjpargeter-Freepik

Published on:

05 Jul 2025, 1:21 pm

Delirium affected 44% of critically ill patients in an Ohio medical center who were hospitalized after a recent stroke, according to new research published in American Journal of Critical Care (AJCC)^[1].

Incidence rates were highest for patients with intracerebral hemorrhage (ICH), with 60% having delirium for at least one day.

The prospective, observational cohort study was conducted in the neurosciences critical care unit (NCCU) at The Ohio State University (OSU) Wexner Medical Center, Columbus. The 16-bed NCCU is part of the hospital’s Comprehensive Stroke Center and the only unit in Central Ohio with comprehensive specialized monitoring capabilities for neurological functions.

“Delirium Among Critically Ill Patients With Stroke: Prevalence, Severity, and Outcomes^[2]” is among the first studies to look at delirium in a cohort of only critically ill patients hospitalized because of a stroke. Researchers from the medical center and OSU College of Nursing contributed to the work.

The occurrence of delirium alone was associated with a variety of adverse outcomes and longer stays for stroke patients, with those having higher delirium severity also experiencing the worst outcomes.

Thomas Lawson, PhD, APRN-CNP, ACNP-BC

Having had delirium, even for a single day, was associated with more days receiving mechanical ventilation, longer length of stay, lower likelihood of discharge to home and higher odds of a score of 3 or higher on the modified Rankin Scale (mRS) at discharge, indicating an unfavorable outcome.

Mortality rates, both while in the NCCU and prior to discharge from the hospital, were not significantly different between those who ever had delirium and those who had not.

By focusing exclusively on patients who were critically ill after a stroke, our study provides important insight into the association between delirium and adverse outcomes among stroke patients, further underscoring the importance of delirium prevention and treatment.

Thomas Lawson, PhD, APRN-CNP, ACNP-BC, a co-author of the study and lead advanced practice provider (NCCU).

Between January and December 2022, the researchers assessed 269 patients for possible eligibility, and the final analysis included data from 169 patients. More than half had recently experienced acute ischemic stroke (AIS, 54.7%), with a third diagnosed with ICH (34.7%) and the remainder diagnosed with aneurysmal subarachnoid hemorrhage (aSAH, 11.2%).

Trained study staff assessed each participating patient for delirium daily for up to seven days while patients were in the NCCU. Delirium was measured with the Confusion Assessment Method for the ICU (CAM-ICU-7), a seven-point delirium severity tool. Patients deemed to have delirium for at least one day were included in the delirium numbers.

References:

1) https://doi.org/10.4037/ajcc2025153

(Newswise/DJR)

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