Serum C-reactive protein adds predictive value for post-stroke delirium

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Several studies involving postoperative patients have suggested that CRP is associated with the core symptoms of delirium by affecting neural pathways and systemic inflammation. Addition of the CRP values to clinical predictors of delirium in postoperative patients has improved the prediction of postoperative patients at risk, as well as the duration and severity of delirium. The current study confirmed and extended the usefulness of CRP in predicting delirium among acute stroke patients with two models based on clinical features.

Data involving patients who were admitted to the hospital within 24 h after a stroke or TIA and had CRP values were obtained from the Prospective Observational Polish Study. The CRP value was added to two models to determine the predictability of delirium: Model A, age and stroke severity; and Model B, stroke severity, atrial fibrillation, diabetes mellitus, pre-stroke dependency, and hemorrhagic stroke.

Of the 459 patients with an acute stroke, 29.2% developed delirium.

Patients who developed delirium had higher CRP levels at the time of admission than patients who did not develop delirium (13.2 mg/L vs. 4.4 mg/L). The cut-off value at which CRP added to the prediction of delirium was > 7.09 mg/L.

Addition of the CRP value improved the predictability of Models A and B.