Clinical profile of acute confusional state in elderly patients in a tertiary hospital in western Rajasthan

Context: Acute confusional state can be predisposed by preexisting chronic health conditions and drug/substance abuse or can be precipitated by acute insults such as infections and electrolyte imbalance. It is more common in the elderly population, and adverse outcomes include prolonged hospital stay and increased risk of complication or mortality. Aims: The aim of this study was to find out the clinical profile of confusional state in western Rajasthan. Settings and Design: This was a cross-sectional prospective design. Materials and Methods: The study was conducted on 180 elderly patients presenting with acute confusional state diagnosed according to the Confusion Assessment Method Instrument. After a thorough history, all patients went through a complete physical examination and were monitored systematically every 12 h until discharge or death. Routine blood tests were done in all the patients and imaging done as indicated. Statistical Analysis: SPSS was used for statistical analysis. Results: Predominantly affected group in both the genders was 60–70 years. One hundred and fifty-one patients had a history of comorbid illnesses, 47.78' of the patients had a significant history of substance abuse, and 137 had psychosomatic disorders. Around one-third of the study population was socially isolated. The most common acute insults were metabolic encephalopathy, infection, and dehydration. Hypoactive delirium was found to be most common (72.77'). Almost half of the patients presenting with confusion (49.5') expired. Vasopressor and ventilator support were required in more than half of the patients. Most of the patients had multiple causes for confusion with only 10.5' of the patients having a single cause. Conclusion: Timely diagnosis and appropriate interventions are necessary to reduce hospital stay and further complications associated with it.