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Acute confusional state/delirium: An etiological and prognostic evaluation
Dheeraj Rai1, Ravindra Kumar Garg1, Hardeep Singh Malhotra1
1Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Annals of Indian Academy of Neurology
|April 23, 2014
Summary
Identifying the cause of acute confusional state (delirium) in elderly patients significantly improves prognosis. Prompt diagnosis and treatment are crucial for reducing mortality and hospital stay.
Area of Science:
- Geriatric Medicine
- Neurology
- Internal Medicine
Background:
- Acute confusional state, or delirium, is a common reason for hospitalization in elderly individuals.
- It presents as fluctuating cognitive impairment and inattention, necessitating prompt recognition and management to reduce associated morbidity and mortality.
Purpose of the Study:
- To investigate the causes and prognostic factors of acute confusional state in elderly patients.
- To evaluate the impact of identifying a precipitating cause on patient outcomes.
Main Methods:
- A retrospective study of 52 elderly patients diagnosed with acute confusional state.
- Clinical evaluation, biochemical blood tests, cerebrospinal fluid analysis, neuroimaging, and assessment of disability using the modified Barthel index (MBI).
- Follow-up for 3 months to assess outcomes.
Main Results:
- A precipitating cause was identified in 33 patients. Leukocytosis and hyponatremia were common findings.
- Patients with an identified cause had significantly lower mortality, shorter hospital stays, and less disability at 3 months.
- Age, comorbidities, serum creatinine, abnormal neuroimaging, and MBI scores were significant prognostic indicators.
Conclusions:
- Identifying a precipitating cause for acute confusional state in elderly patients is associated with a better prognosis.
- This includes reduced mortality and shorter hospital duration, highlighting the importance of thorough etiological investigation.
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