Research Paper

Clinico-etiological Profile Of Patients With Acute Confusional State

Abstract :

Introduction: Delirium, a term used to describe Acute Confusional state(ACS), does not suggest a specific diagnosis but rather a manifestation of wide range of medical conditions. As etiology of ACS are numerous, proper and prompt identification can help us to treat underlying disorder and thus prevent fatal outcome.Aims: To study the Clinical and etiological profile of Acute Confusional State in a tertiary care hospital.Design: Prospective and observational study.Materials and methods: This study included 200 patients admitted with ACS of less than 7 days duration diagnosed according to Confusion Assessment method. A detailed history and examination was done. All patients were subjected to hemogram, complete urine examination, renal and liver function tests, serum electrolytes and arterial blood gas analysis. In selected patients blood and urine cultures, CSF analysis, CT and MRI Brain were done as per clinical suspicion.Results: Out of 200 patients, males were 124, females were 76 and divided into three groups based on age, 44 patients in younger age group(18-30 years), 97 patients in middle age group (31-60 years) and 59 patients in old age group (61-90 years).Overall the most common cause of ACS was found to be metabolic(37%) followed by cereovascular disorder(CVA) (29%).In younger patients, the most common cause was found to be CNS infections(28.5%) followed by CVA(26.5%) and autoimmune disorders(18.5%).In middle age group,common etiologies were CVA(34%) followed by hepatic encephalopathy(19.7%) and CNS infections(16%). In elderly patients most common causes were found to be metabolic (38%) followed by CVA (35%) and septic causes (25%).Conclusion: Acute Confusional state is a very common condition encountered in clinical practice. Many causes of ACS are completely reversible like infections, metabolic abnormalities. This finding emphasize the great importance of early and accurate etiological diagnosis of ACS, as it can help in better management of patients.

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