Evaluation of Delirium in Elderly Hospitalised Patients in a Tertiary Care Hospital

Abstract

Objective: Delirium is common in older hospitalized patients and may indicate a life- threatening condition, where a prompt and appropriate evaluation is required for assessment and prevention of the disease which should be done at the time of admission and continue throughout the hospital stay. The present study was undertaken to evaluate delirium in elderly (>65 years) hospitalized patients in a tertiary care hospital and to monitor outcome after 1 month. Methods: This prospective observational study was carried out in the Department of General Medicine of M.K.C.G. Medical College and hospital, Berhampur, Odisha, India from August 2019 to September 2021. After clinical evaluation and diagnosis as delirium patients using (confusion assessment method) score, 50 patients (65 years and above) were selected for the study. Patients with dementia, any psychiatric condition, trauma, intoxication, and poisoning were excluded from the study. They were evaluated for etiology and then followed up for 1 month for outcome. Results: In this present study of 50 patients, 33 were male and 17 were female. About 64% belong to age group 65–75 years. Most common type of delirium was hyperactive (40%). The most common etiologies were hyponatremia (38%), infection (22%), and cerebrovascular accident (16%). Majority of population had both type 2DM (diabetes mellitus) and HTN (Hypertension) (38%). Overall recovery rate was better in metabolic causes (89.4%), most fatal was uremia followed by intracranial bleed. Lower (Glasgow coma scale) score at the time of admission indicates poor prognosis. Conclusion: Delirium in elderly patients is a medical emergency which needs prompt diagnosis and evaluation helping the family and physicians for better management with a good prognosis.