A systematic review of the impact of delirium on allied health interventions: A surprising lack of data.

Abstract

Abstract: Background & Objectives: There is increasing interest in the impact of delirium on mortality and morbidity in stroke patients. Whilst there are published studies assessing this impact, they are primarily focused on the short/long-term physical and cognitive outcomes of stroke survivors. We conducted a systematic review of the literature to determine the impact of delirium on participation in allied health interventions and measurable outcomes immediately following a stroke. Methods and Results: We used a broad search strategy and interrogated three online databases; CINAHL, EMBASE and MEDLINE. Our initial search yielded no results specific to stroke. The search was then expanded to include studies in any patient population and the final result yielded two publications that fulfilled inclusion criteria. One was a case report of a post-arthroplasty patient, and the second an observational study in an ICU. Both groups concluded that delirium had a negative impact on participation in allied health therapy. Conclusion: The lack of research on the impact of delirium on participation in allied health therapies in stroke patients is surprising. Intuitively, we would assume a negative association but this needs to be studied systematically to identify the incidence, risk factors, and potential interventions aimed at improving outcomes. The overall management of stroke must keep pace with the gains shown in hyperacute stroke management to ensure maximal benefit to stroke survivors.