000K  utf8
1100  $c2022
1500  eng
2050  urn:nbn:de:gbv:8:3-2024-00317-8
2051  10.1007/s00415-022-11000-6
3000  Nydahl, Peter
3010  Baumgarte, Friederike
3010  Berg, Daniela Dagmar Denise
3010  Bergjan, Manuela
3010  Borzikowsky, Christoph
3010  Franke, Christiana
3010  Green, Diana
3010  Hannig, Anisa
3010  Hansen, Hans Christian
3010  Hansen, Uta
3010  Hauss, Armin
3010  Istel, Rahel
3010  Krämer, Norma
3010  Krause, Karita
3010  Lohrmann, Renée
3010  Margraf, Nils G
3010  Meyne, Johannes
3010  Mohammadzadeh-Vazifeh, Mohammad
3010  Osterbrink, Jürgen
3010  Palm, Frederick
3010  Petersen, Telse
3010  Schöller, Bernd
3010  Stolze, Henning
3010  Zilezinski, Max
4000  Delirium on stroke units: a prospective, multicentric quality-improvement project$hSpringer Science and Business Media LLC  [Nydahl, Peter]
4030  $nSpringer Science and Business Media LLC
4209  Background Post-stroke delirium (POD) in patients on stroke units (SU) is associated with an increased risk for complications and poorer clinical outcome. The objective was to reduce the severity of POD by implementing an interprofessional delirium-management. Methods Multicentric quality-improvement project on five SU implementing a delirium-management with pre/post-comparison. Primary outcome was severity of POD, assessed with the Nursing Delirium Screening Scale (Nu-DESC). Secondary outcome parameters were POD incidence, duration, modified Rankin Scale (mRS), length of stay in SU and hospital, mortality, and others. Results Out of a total of 799 patients, 59.4% (n = 475) could be included with 9.5% (n = 45) being delirious. Implementation of a delirium-management led to reduced POD severity; Nu-DESC median: pre: 3.5 (interquartile range 2.6-4.7) vs. post 3.0 (2.2-4.0), albeit not significant (p = 0.154). Other outcome parameters were not meaningful different. In the post-period, delirium-management could be delivered to 75% (n = 18) of delirious patients, and only 24 (53.3%) of delirious patients required pharmacological treatments. Patients with a more severe stroke and POD remained on their disability levels, compared to similar affected, non-delirious patients who improved. Conclusions Implementation of delirium-management on SU is feasible and can be delivered to most patients, but with limited effects. Nursing interventions as first choice could be delivered to the majority of patients, and only the half required pharmacological treatments. Delirium-management may lead to reduced severity of POD but had only partial effects on duration of POD or length of stay. POD hampers rehabilitation, especially in patients with more severe stroke. Registry DRKS, DRKS00021436. Registered 04/17/2020, www.drks.de/DRKS00021436 .
4950  https://doi.org/10.1007/s00415-022-11000-6$xR$3Volltext$534
4950  https://nbn-resolving.org/urn:nbn:de:gbv:8:3-2024-00317-8$xR$3Volltext$534
4961  https://macau.uni-kiel.de/receive/macau_mods_00004599
5051  610
5550  Delirium
5550  Delirium
5550  encephalopathy
5550  Humans
5550  Incidence
5550  Postoperative Complications
5550  Prospective Studies
5550  Quality Improvement
5550  Quality-improvement
5550  Registries
5550  Risk Factors
5550  Stroke
5550  Stroke