Although post-stroke delirium is a frequent complication in acute settings and has significant long-lasting implications for patients, the prevalence of post-stroke delirium diagnosed according to gold-standard criteria remains uncertain. This highlights the importance of updating the current evidence. This review aims to provide a precise estimation of the prevalence of delirium in acute post-stroke settings and to explore potential differences in the reported prevalence according to the characteristics of the study and stroke survivors. Systematic review and meta-analysis. Post-stroke survivors with delirium in acute settings. Five English and two Chinese language databases from inception to June 2023, and the reference lists of published reviews. Studies reporting the prevalence of post-stroke delirium according to the Diagnostic and Statistical Manual of Mental Disorders criteria with the description of assessment method in the absence of interventions for delirium were eligible. Two reviewers independently screened searched records and extracted data from eligible studies. A meta-analysis was conducted using a random-effects model to evaluate the prevalence of post-stroke delirium, and predefined subgroup analyses, sensitivity analyses, and mixed-effects meta-regression were conducted to explore the contribution of heterogeneity. Twenty-nine eligible studies involving 8839 survivors were included. In acute settings, the overall weighted prevalence of post-stroke delirium was 25 % (95 % CI, 20–30; , 95 %). Subgroup analyses revealed age-dependent variations in delirium prevalence, with rates of 20 %, 25 %, and 34 % for ages 60–64, 65–74, and 75–79, respectively. Delirium prevalence varied by assessment duration (7 days: 31 %, >7 days: 24 %, <7 days: 20 %). Initial screening significantly reduced reported prevalence to 15 %, compared with 30 % when no initial screening was conducted. Delirium prevalence was lower when nurses were involved in assessments (13 % vs. 29 %). No significant effects were detected for economic status, publication year, female percentage, onset-to-admission time, stroke type, and assessment frequency. Meta-regression analysis revealed that higher delirium prevalence was associated with increased survivors' age (β = 0.051; 95 % CI, −0.0002 to 0.103; = 0.05; R = 13.36 %). A high prevalence of post-stroke delirium was observed in acute settings. Nurses are required to integrate and coordinate the prevention, early detection, and management of delirium following stroke into their nursing practice, particularly for older stroke survivors. The findings necessitate the need for incorporating specialized training within nursing education to identify and manage the delirium effectively and accurately. This reinforces the pivotal role of nurses in the early detection and prevention of delirium within the acute stroke care continuum. The protocol was registered on PROSPERO (CRD42022352097). Evidence suggests 25 % prevalence of post-stroke delirium in acute settings, with higher rates in older patients, emphasizing the need for prevention, early detection, and management in nursing practice.

中文翻译：

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急性情况下中风后谵妄的患病率：系统评价和荟萃分析

尽管中风后谵妄是急性环境中常见的并发症，并且对患者具有显着的长期影响，但根据金标准诊断的中风后谵妄的患病率仍不确定。这凸显了更新当前证据的重要性。本综述旨在准确估计急性中风后谵妄的患病率，并根据研究和中风幸存者的特征探讨报告的患病率的潜在差异。系统回顾和荟萃分析。中风后幸存者在急性环境中出现谵妄。从成立到 2023 年 6 月的五个英文数据库和两个中文数据库，以及已发表评论的参考文献列表。根据精神障碍诊断和统计手册标准报告中风后谵妄患病率的研究，并描述在没有谵妄干预措施的情况下的评估方法，是合格的。两名评审员独立筛选检索记录并从符合条件的研究中提取数据。使用随机效应模型进行荟萃分析来评估中风后谵妄的患病率，并进行预定义的亚组分析、敏感性分析和混合效应荟萃回归来探讨异质性的贡献。纳入了涉及 8839 名幸存者的 29 项符合条件的研究。在急性环境中，卒中后谵妄的总体加权患病率为 25%（95% CI，20-30；95%）。亚组分析显示谵妄患病率存在​​年龄依赖性差异，60-64 岁、65-74 岁和 75-79 岁的谵妄患病率分别为 20%、25% 和 34%。谵妄发生率因评估持续时间而异（7 天：31 %，> 7 天：24 %，< 7 天：20 %）。初次筛查将报告的患病率显着降低至 15%，而未进行初次筛查时则为 30%。当护士参与评估时，谵妄发生率较低（13% vs. 29%）。经济状况、发表年份、女性比例、发病到入院时间、卒中类型和评估频率没有发现显着影响。荟萃回归分析显示，谵妄患病率较高与幸存者年龄增加相关（β = 0.051；95 % CI，-0.0002 至 0.103；= 0.05；R = 13.36 %）。在急性环境中观察到中风后谵妄的患病率很高。护士需要将中风后谵妄的预防、早期发现和管理整合和协调到他们的护理实践中，特别是对于老年中风幸存者。研究结果表明，需要将专门培训纳入护理教育中，以有效、准确地识别和管理谵妄。这强化了护士在急性中风护理连续过程中早期发现和预防谵妄的关键作用。该协议已在 PROSPERO 上注册（CRD42022352097）。有证据表明，急性情况下中风后谵妄的患病率为 25%，老年患者的患病率更高，这强调了护理实践中预防、早期发现和管理的必要性。