Incidence and predictive factors of intensive care unit delirium in acute stroke patients: a secondary data analysis

For patients admitted to Intensive Care Units (ICUs) with acute stroke, ICU delirium can compound an already complex hospitalization. The incidence of ICU delirium in patients with acute stroke ranges from 12% to 75%. Development of delirium has been associated with increased risk of mortality, increased length of ICU stay, increased healthcare costs, impaired cognition, and decreased functional independence. Prediction models would facilitate recognition of those at greatest risk for delirium, improve understanding of acute delirium events, and enhance early implementation of interventions. Current models for predicting delirium specifically in acute stroke patients have limited generalizability and clinical applicability. The purposes of this secondary data analysis were to determine the incidence of delirium in patients admitted to the ICU with acute stroke and to examine the relationship between underexplored factors that may be associated with the development of ICU delirium in this population. Supported by primary prevention within prevention theory, a retrospective, descriptive, correlational study was conducted. Using data extracted from the electronic medical record (EMR), descriptive statistics were used to analyze demographic data and the incidence of delirium. A logistic regression with binary outcomes statistical analysis was employed to determine the extent to which factors can predict ICU delirium in adult patients admitted to the ICU with acute stroke. Results indicated a total of 501 of the 2,388 stroke patients in this sample developed delirium at least once during their hospitalization, suggesting an incidence of ICU delirium of 20.98%. Of the 501 patients that developed delirium, 42.12% did so within 24 hours of admission to the ICU, and 60.68% did so within 48 hours of admission to the ICU. The final regression model suggested factors significantly associated with development of delirium included type of stroke; history of vision impairment, schizophrenia, or dementia; first RASS score; first MORSE Fall Risk Scale score consistent with “High Fall Risk;” first BG above normal limits; placement of nasogastric tube, peripheral line, or peripherally inserted central catheter within 24 hours of ICU admission; transferring to interventional radiology (IR) or neuro operating room (OR) within 24 hours of ICU admission; and occurrence of fever > 100 degrees Fahrenheit. Though these factors are mostly non-modifiable in nature, these data do support a better understanding of the critically ill acute stroke patients most at risk for developing delirium. Findings from this study had implications related to nursing practice, policy, and theory.

Name thesis:degree_name

Ph.D. (Doctor of Philosophy)

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Nursing (UMKC)

Grantor

University of Missouri--Kansas City

Year dc:date.issued

2026

Author dc:creator

• Callahan, Mary Katherine

Advisor dc:contributor.advisor

• Lasiter, Sue

Language dc:language.iso

en_US

Handle dc:identifier.uri

https://hdl.handle.net/10355/112324

OAI identifier oai:identifier

oai:mospace.umsystem.edu:10355/112324