Delirium pattern in hospitalized patients of a tertiary care rural hospital: An observational study

Delirium, an acute and often fluctuating disorder of attention and cognition, poses significant challenges in clinical care due to its varied presentation and complex etiological factors. In rural healthcare settings, where resources and awareness are limited, delirium is frequently under-recognized and inadequately managed.

To investigate the factors associated with and types of delirium and their correlation with sociodemographic profiles in hospitalized patients at a tertiary care rural hospital in Central India.

This cross-sectional observational study was conducted on 120 patients diagnosed with delirium and referred to the Department of Psychiatry. A comprehensive assessment was performed using the Delirium Etiology Checklist (DEC) and Richmond Agitation Sedation Scale (RASS), and data spanning various associated factors, subtypes, and demographic variables were analyzed using SPSS version 27.0.

The cohort had a mean age of 48.2 ± 15.96 years, with a predominance of male patients (84.2%). Substance withdrawal (16.96%), anemia (12.5%), and renal derangement (11.6%) emerged as the major factors associated with delirium. Hyperactive delirium was observed in 88.3% of patients, while hypoactive delirium was found in 11.7%. A significant association was noted between cardiac decompensation and sepsis with hypoactive delirium, while substance withdrawal with hyperactive delirium.

The study highlights the need for a systematic approach to identify and manage delirium's underlying associated factors, particularly in resource-limited settings, to prevent adverse outcomes.