{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:22:53Z","timestamp":1790270573072,"version":"4.1.0"},"reference-count":28,"publisher":"AACN Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Delirium is a common complication of critical illness, but the epidemiology of delirium among stroke patients with critical illness is uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the prevalence, severity, and short-term outcomes of delirium in adults admitted to a neurocritical care unit with acute ischemic stroke, intracerebral hemorrhage, and aneurysmal subarachnoid hemorrhage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective, observational cohort study was conducted in a neurocritical care unit in the United States. Patients were enrolled within 48 hours of stroke symptom onset. Delirium was assessed daily until study day 7 (or until transfer out of the neurocritical care unit) with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the CAM-ICU-7 delirium severity score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 44.4% of patients in the cohort had delirium. Prevalence was higher among patients with intracerebral hemorrhage (38%, 60%, and 32% in patients with acute ischemic stroke, intracerebral hemorrhage, and aneurysmal subarachnoid hemorrhage, respectively). Mean CAM-ICU-7 score for patients who had delirium was 5.64. Regression analyses showed patients with delirium had more ventilator days (point estimate, 2.59; 95% CI, 0.73-4.44), longer ICU and hospital lengths of stay (point estimates, 3.33 [95% CI, 1.36-5.31] and 6.76 [3.43-10.09], respectively), lower odds of discharge home (odds ratio, 0.42; 95% CI, 0.19-0.94), and higher odds of worse modified Rankin score of 3 or higher at discharge (odds ratio, 2.58; 95% CI, 1.04-6.36). Higher delirium severity resulted in worse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Delirium is common among critically ill stroke patients, especially those with intracerebral hemorrhage, and patients who experience delirium have worse outcomes. Increasing severity of delirium is associated with adverse outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ajcc2025153","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T02:01:40Z","timestamp":1751248900000},"page":"266-273","source":"Crossref","is-referenced-by-count":2,"title":["Delirium Among Critically Ill Patients With Stroke: Prevalence, Severity, and Outcomes"],"prefix":"10.4037","volume":"34","author":[{"given":"Thomas N.","family":"Lawson","sequence":"first","affiliation":[{"name":"Thomas N. Lawson is a lead advanced practice provider, Neurocritical Care Unit, The Ohio State University Wexner Medical Center, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alai","family":"Tan","sequence":"additional","affiliation":[{"name":"Alai Tan is a research professor, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"McNett","sequence":"additional","affiliation":[{"name":"Molly McNett is a professor of clinical nursing, Helene Fuld Health Trust National Institute for EBP, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Balas","sequence":"additional","affiliation":[{"name":"Michele C. Balas is an associate dean for research and Dorothy Hodges Olson Chair in Nursing, University of Nebraska Medical Center College of Nursing, Omaha."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Brinda","sequence":"additional","affiliation":[{"name":"Amy Brinda was a graduate student and is now a psychiatric nurse practitioner, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan E.","family":"Brummel","sequence":"additional","affiliation":[{"name":"Nathan E. Brummel is an associate professor, The Ohio State University College of Medicine, Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary B.","family":"Happ","sequence":"additional","affiliation":[{"name":"Mary B. Happ is a distinguished professor of critical care research, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Tate","sequence":"additional","affiliation":[{"name":"Judith A. Tate is an associate professor, The Ohio State University College of Nursing, Columbus."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"key":"2025063022013686000_b1-0340266","unstructured":"World Health Organization\n          . The top 10 causes of death. Accessed October 20, 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/the-top-10-causes-of-death"},{"issue":"9","key":"2025063022013686000_b2-0340266","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics-2020 update: a report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"2025063022013686000_b3-0340266","doi-asserted-by":"publisher","first-page":"e008961","DOI":"10.1161\/CIRCOUTCOMES.122.008961","article-title":"Patterns and outcomes of intensive care on acute ischemic stroke patients in the US","author":"Santos","year":"2023","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"10","key":"2025063022013686000_b4-0340266","doi-asserted-by":"publisher","first-page":"e876","DOI":"10.1097\/CCM.0000000000004492","article-title":"Long-term mortality among ICU patients with stroke compared with other critically ill patients","volume":"48","author":"van Valburg","year":"2020","journal-title":"Crit Care Med"},{"key":"2025063022013686000_b5-0340266","unstructured":"Jackson\u2008G, Chari\u2008K. National Hospital Care Survey Demonstration Projects: stroke inpatient hospitalizations. Natl Health Stat Reports. 2019;132:1\u20137. https:\/\/www.cdc.gov\/nchs\/data\/nhsr\/nhsr132-508.pdf"},{"key":"2025063022013686000_b6-0340266","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11309-2","article-title":"Impact of delirium on the outcome of stroke: a prospective, observational, cohort study","author":"Rollo","year":"2022","journal-title":"J Neurol"},{"issue":"1","key":"2025063022013686000_b7-0340266","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1186\/s12883-022-02756-5","article-title":"The relationship of acute delirium with cognitive and psychiatric symptoms after stroke: a longitudinal study","volume":"22","author":"Nerdal","year":"2022","journal-title":"BMC Neurol"},{"key":"2025063022013686000_b8-0340266","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1001\/jama.291.14.1753","article-title":"Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit","volume":"291","author":"Ely","year":"2004","journal-title":"JAMA"},{"issue":"3","key":"2025063022013686000_b9-0340266","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/JNN.0000000000000642","article-title":"A scoping review of the incidence, predictors, and outcomes of delirium among critically ill stroke patients","volume":"54","author":"Lawson","year":"2022","journal-title":"J Neurosci Nurs"},{"issue":"9","key":"2025063022013686000_b10-0340266","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1007\/s00134-017-4860-7","article-title":"The intensive care delirium research agenda: a multinational, interprofessional perspective","volume":"43","author":"Pandharipande","year":"2017","journal-title":"Intensive Care Med"},{"issue":"22","key":"2025063022013686000_b11-0340266","doi-asserted-by":"publisher","first-page":"2983","DOI":"10.1001\/jama.289.22.2983","article-title":"Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS)","volume":"289","author":"Ely","year":"2003","journal-title":"JAMA"},{"issue":"10","key":"2025063022013686000_b12-0340266","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"issue":"21","key":"2025063022013686000_b13-0340266","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU)","volume":"286","author":"Ely","year":"2001","journal-title":"JAMA"},{"key":"2025063022013686000_b14-0340266","unstructured":"Boehm\u2008L, Pun\u2008BT, Stollings\u2008J. Confusion Assessment Method for the ICU (CAM-ICU): The Complete Training Manual. Updated August 2016. https:\/\/www.icudelirium.org\/resource-downloads\/cam-icu-training-manual"},{"issue":"5","key":"2025063022013686000_b15-0340266","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1097\/CCM.0000000000002368","article-title":"The Confusion Assessment Method for the ICU-7 Delirium Severity Scale: a novel delirium severity instrument for use in the ICU","volume":"45","author":"Khan","year":"2017","journal-title":"Crit Care Med"},{"issue":"1","key":"2025063022013686000_b16-0340266","doi-asserted-by":"publisher","first-page":"R19","DOI":"10.1186\/cc6793","article-title":"Combined didactic and scenario-based education improves the ability of intensive care unit staff to recognize delirium at the bedside","volume":"12","author":"Devlin","year":"2008","journal-title":"Crit Care"},{"issue":"7","key":"2025063022013686000_b17-0340266","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1161\/STROKEAHA.117.017866","article-title":"Evolution of the Modified Rankin Scale and its use in future stroke trials","volume":"48","author":"Broderick","year":"2017","journal-title":"Stroke"},{"issue":"5","key":"2025063022013686000_b18-0340266","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1177\/003693305700200504","article-title":"Cerebral vascular accidents in patients over the age of 60. II. Prognosis","volume":"2","author":"Rankin","year":"1957","journal-title":"Scott Med J"},{"issue":"11","key":"2025063022013686000_b19-0340266","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1164\/rccm.201307-1256OC","article-title":"Intracerebral hemorrhage and delirium symptoms. Length of stay, function, and quality of life in a 114-patient cohort","volume":"188","author":"Naidech","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"2025063022013686000_b20-0340266","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.psym.2016.07.004","article-title":"Agitation, delirium, and cognitive outcomes in intracerebral hemorrhage","volume":"58","author":"Rosenthal","year":"2017","journal-title":"Psychosomatics"},{"issue":"11","key":"2025063022013686000_b21-0340266","doi-asserted-by":"publisher","first-page":"105219","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105219","article-title":"Identifying delirium early after stroke: a new prediction tool for the intensive care unit","volume":"29","author":"Haight","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"1","key":"2025063022013686000_b22-0340266","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1080\/13607863.2015.1035695","article-title":"Delirium in critical care: a study of incidence, prevalence, and associated factors in the tertiary care hospital of older Thai adults","volume":"20","author":"Limpawattana","year":"2016","journal-title":"Aging Mental Health"},{"issue":"10","key":"2025063022013686000_b23-0340266","doi-asserted-by":"publisher","first-page":"3325","DOI":"10.1161\/STROKEAHA.120.033005","article-title":"Economic impact of poststroke delirium and associated risk factors: findings from a prospective cohort study","volume":"52","author":"Zipser","year":"2021","journal-title":"Stroke"},{"key":"2025063022013686000_b24-0340266","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.jcrc.2019.12.008","article-title":"Fluctuations of consciousness after stroke: associations with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and potential undetected delirium","volume":"56","author":"Reznik","year":"2020","journal-title":"J Crit Care"},{"key":"2025063022013686000_b25-0340266","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.jcrc.2021.02.010","article-title":"Hyperactive delirium in patients after non-traumatic subarachnoid hemorrhage","volume":"64","author":"Reimann","year":"2021","journal-title":"J Crit Care"},{"issue":"8","key":"2025063022013686000_b26-0340266","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart disease and stroke statistics-2022 update: a report from the American Heart Association","volume":"145","author":"Tsao","year":"2022","journal-title":"Circulation"},{"issue":"2","key":"2025063022013686000_b27-0340266","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1097\/CCM.0b013e318232da12","article-title":"Poststroke delirium incidence and outcomes: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)","volume":"40","author":"Mitasova","year":"2012","journal-title":"Crit Care Med"},{"issue":"2","key":"2025063022013686000_b28-0340266","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1007\/s12028-022-01612-1","article-title":"A pilot study of the Fluctuating Mental Status Evaluation: a novel delirium screening tool for neurocritical care patients","volume":"38","author":"Reznik","year":"2022","journal-title":"Neurocritical Care"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/34\/4\/266\/163953\/266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/34\/4\/266\/163953\/266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T02:01:44Z","timestamp":1751335304000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/34\/4\/266\/32776\/Delirium-Among-Critically-Ill-Patients-With-Stroke"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2025153","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}