Comparative etiological analysis of critical patients presenting to the emergency department with altered consciousness across age groups: A prospective observational study

IF 0.8 4区 医学 Q4 EMERGENCY MEDICINE
Harun Yildirim, E. Armağan, Ataman Kose, S. Eraybar, E. Ahun, Pinar Cinar Sert
{"title":"Comparative etiological analysis of critical patients presenting to the emergency department with altered consciousness across age groups: A prospective observational study","authors":"Harun Yildirim, E. Armağan, Ataman Kose, S. Eraybar, E. Ahun, Pinar Cinar Sert","doi":"10.1002/hkj2.12022","DOIUrl":null,"url":null,"abstract":"The aim of our study is to assess the relationship between altered consciousness in patients presenting to the emergency department (ED) without a history of trauma and the physiological changes associated with aging. Additionally, we aim to compare diagnostic differences between patients under the age of 65 and those aged 65 and above.This prospective study was conducted at the ED of Uludağ University Medical Faculty Hospital over a 1‐year period from December 2012 to November 2013. Patients aged 18 and above presenting with non‐traumatic altered consciousness were included, and they were categorized into two groups based on age: <65 years and ≥65 years. Comparison between age groups included gender, seasonal presentation, vital signs, consciousness level, Glasgow Coma Scale (GCS) score, requested consultations, diagnoses, and outcomes.Out of 646 patients, 312 (48%) were female, and 334 (52%) were male, with a mean age of 64.9 ± 16.4 years. The highest number of admissions for altered consciousness occurred during the summer season (n = 200, 31%). In the 65 and above age group, a statistically significant elevation was found in the mean systolic blood pressure (p < 0.05). In neurological diagnoses, cerebrovascular events were observed most frequently, while in non‐neurological diagnoses, endocrine/metabolic diseases were more common. It was observed that GCS scores were lower in neurological diagnoses (p = 0.020). Discharges were more frequent in the under 65 age group, with a statistically significant difference (p < 0.05). It was found that the mortality rate was higher in non‐neurological diagnoses, and this was statistically significant (p < 0.001).When determining the cause of altered consciousness in patients with such symptoms, a comprehensive understanding of physiological changes in elderly individuals is crucial. While high blood pressure may indicate neurological diagnoses, tachycardia, tachypnea, and fever may suggest non‐neurological causes.","PeriodicalId":50401,"journal":{"name":"Hong Kong Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hong Kong Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/hkj2.12022","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

The aim of our study is to assess the relationship between altered consciousness in patients presenting to the emergency department (ED) without a history of trauma and the physiological changes associated with aging. Additionally, we aim to compare diagnostic differences between patients under the age of 65 and those aged 65 and above.This prospective study was conducted at the ED of Uludağ University Medical Faculty Hospital over a 1‐year period from December 2012 to November 2013. Patients aged 18 and above presenting with non‐traumatic altered consciousness were included, and they were categorized into two groups based on age: <65 years and ≥65 years. Comparison between age groups included gender, seasonal presentation, vital signs, consciousness level, Glasgow Coma Scale (GCS) score, requested consultations, diagnoses, and outcomes.Out of 646 patients, 312 (48%) were female, and 334 (52%) were male, with a mean age of 64.9 ± 16.4 years. The highest number of admissions for altered consciousness occurred during the summer season (n = 200, 31%). In the 65 and above age group, a statistically significant elevation was found in the mean systolic blood pressure (p < 0.05). In neurological diagnoses, cerebrovascular events were observed most frequently, while in non‐neurological diagnoses, endocrine/metabolic diseases were more common. It was observed that GCS scores were lower in neurological diagnoses (p = 0.020). Discharges were more frequent in the under 65 age group, with a statistically significant difference (p < 0.05). It was found that the mortality rate was higher in non‐neurological diagnoses, and this was statistically significant (p < 0.001).When determining the cause of altered consciousness in patients with such symptoms, a comprehensive understanding of physiological changes in elderly individuals is crucial. While high blood pressure may indicate neurological diagnoses, tachycardia, tachypnea, and fever may suggest non‐neurological causes.
不同年龄段急诊科意识改变危重病人的病因比较分析:前瞻性观察研究
我们的研究旨在评估急诊科(ED)无外伤史患者的意识改变与衰老相关生理变化之间的关系。这项前瞻性研究于 2012 年 12 月至 2013 年 11 月在乌鲁达大学医学院附属医院急诊科进行,为期 1 年。这项前瞻性研究于 2012 年 12 月至 2013 年 11 月在乌鲁达大学医学院附属医院急诊室进行,为期 1 年。研究纳入了 18 岁及以上出现非外伤性意识改变的患者,并根据年龄将他们分为两组:年龄<65岁和≥65岁。年龄组之间的比较包括性别、季节性表现、生命体征、意识水平、格拉斯哥昏迷量表(GCS)评分、就诊请求、诊断和结果。夏季因意识改变入院的人数最多(200人,31%)。在 65 岁及以上年龄组中,平均收缩压的升高具有统计学意义(P < 0.05)。在神经系统诊断中,脑血管事件最为常见,而在非神经系统诊断中,内分泌/代谢疾病更为常见。据观察,神经系统诊断的 GCS 评分较低(p = 0.020)。65 岁以下年龄组的出院率更高,差异有统计学意义(p < 0.05)。研究发现,非神经系统诊断的死亡率较高,且具有统计学意义(p < 0.001)。在确定出现此类症状的患者意识改变的原因时,全面了解老年人的生理变化至关重要。高血压可能提示神经系统诊断,而心动过速、呼吸过速和发热则可能提示非神经系统原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.50
自引率
16.70%
发文量
26
审稿时长
6-12 weeks
期刊介绍: The Hong Kong Journal of Emergency Medicine is a peer-reviewed, open access journal which focusses on all aspects of clinical practice and emergency medicine research in the hospital and pre-hospital setting.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信