Acute confusional states (ACS) were studied in 155 consecutive representative patients (mean age 73 years) with acute cerebrovascular disorders. Testing for ACS could be done in 94% of the patients. Sixty-nine of the 145 testable patients (48%) were acutely confused on admission or developed ACS within 7 days of admission. The mean age for the patients who developed ACS was 76 years compared with 69 years for patients without ACS (p < 0.001). Fifty-six of 113 patients (50%) with cerebral infarction, 6 of 21 patients (29%) with transitory ischemic attack and 7 out of 8 patients (88%) with intracerebral hemorrhage developed ACS. ACS were more common in patients with left-sided brain lesions (38/65; 58%) than in patients with right-sided brain lesions (18/47; 38%, p < 0.05). Multivariate analysis showed that extensive extremity paresis, previous ACS, left-sided brain lesions, old age and treatment with drugs with anticholinergic effects were independent predictors for ACS. ACS were associated with poststroke complications such as myocardial infarction, pulmonary embolism, pneumonia, deep vein thrombosis, urinary retention or urinary tract infection. Extensive paresis and ACS were the main independent predictors for discharge to geriatric rehabilitation.
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Gustafson et al. (1991) studied this question.