Association of Atrial Fibrillation and Cardioembolic Stroke with Poststroke Delirium Susceptibility: A Systematic Review and Meta-Analysis of Observational Studies

Several studies have shown atrial fibrillation (AF) and cardioembolic stroke (CES) to be associated with the risk of poststroke delirium (PSD). However, other studies have reported inconsistent results. We performed a comprehensive meta-analysis to clarify the associations between AF and CES and PSD susceptibility. We searched relevant studies meeting inclusion criteria in PubMed, Google Scholar, and Web of Science. Useful data were pooled, and odds ratios and 95% confidence intervals were calculated. We also assessed heterogeneity among studies, performed sensitivity analyses, and estimated publication bias. This meta-analysis containing 18 observational studies proved that AF (odds ratio =2.30, 95% confidence interval = 2.00–2.65, P < 0.0001) was associated with an increased risk of PSD. CES was also found to have a higher risk of delirium compared with other types of stroke based on the Trial of Org 10172 in Acute Stroke Treatment classification (odds ratio = 2.02, 95% confidence interval = 1.47–2.79, P < 0.0001). Our meta-analysis suggested that AF and CES contribute to increased risk of PSD.