All ETDs from UAB

Advisory Committee Chair

Huifeng Yun

Advisory Committee Members

Virginia J Howard

Richard E Kennedy

Document Type


Date of Award


Degree Name by School

Master of Science in Public Health (MSPH) School of Public Health


Delirium is a common neurobehavioral complication following a stroke. Patients who have post-stroke delirium (PSD) are more likely to have severe prognoses, such as physical function decline, high mortality and an increased need for long-term care. Nursing home residents as one of the fragile and special populations sharing the attributes of old age, and high prevalence of chronic diseases and limited mobility. However, there only a few studies have investigated the association between PSD and mortality among individuals admitted to a long-term care facility. This retrospective cohort study aimed to examine the association between PSD and mortality among the participants newly admitted to long-term care facilities and diagnosed with stroke. The data source of this study was a 5% random sample of 2012 Minimum Data Set (MDS) Assessment Summary File 3.0. The independent variable was PSD. The dependent variable was death based on the participants’ last discharge record. Multivariable Poisson regression models were performed to quantify the association. 11,480 stroke participants were included in the final analysis. With the mean age of 79.20 years of the total study sample, 454 (3.95%) participants had a PSD and 1,008 (8.89%) participants died. After conducting the robust Poisson regression and adjusting the potential confounders, we found an increased risk between PSD and mortality 2 (RR=2.65, 95% CI: 2.20, 3.21, P<0.0001). Stratified analyses by age, sex, region, BMI, depression and restorative nursing training yielded similar findings as to the multivariable models. In conclusion, this study found that participants with PSD had a significantly higher risk of mortality compared to those without PSD among the stroke participants admitted into a long-term care facility. This finding emphasizes the importance of health care providers to be attentive to the PSD patients’ outcomes within this population.

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