A study of etiological profile of acute confusional state


  • Jaspreet Kaur Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India
  • Gurinder Mohan Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India
  • S. B. Nayyar Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India
  • Ranjeet Kaur Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India




Acute confusional state, Confusion assessment method, Metabolic encephalopathy, Meningoencephalitis, Septic encephalopathy


Background: ACS (Acute confusional states) are on the rise taking the shape of an epidemic. These states are common among the elderly, but young individuals are also not spared. Prompt diagnosis and management of these states can decrease the associated morbidity and mortality.

Methods: In this prospective observational study, etiological profile of ACS was evaluated in a total 100 patients, selected over a period of one year, after they fulfilled the CAM (Confusion Assessment Method) criteria.

Results: Among 100 patients of ACS, mean age was 54.77±18.50 years, males were 66% and 34% were females. The most common diagnosis provisionally made on the basis of history and clinical examination was metabolic encephalopathy in 37% patients, meningoencephalitis (24%), CVA (Cerebrovascular accident) (18%), seizures (9%), sepsis (6%), poisoning (6%). Whereas the final diagnosis made after subjecting the patients to relevant investigations, was metabolic encephalopathy in 37% of patients, meningoencephalitis (20%), CVA (18%), sepsis (12%), unprovoked seizures (6%), poisoning (6%) and undetermined in 1%. The final diagnosis matched the provisional diagnosis in most of the patients except sepsis as a provisional diagnosis was underdiagnosed. The mean duration of hospital stay was 7.6±3.67days and the hospital stay was most commonly complicated by aspiration pneumonia and acute kidney injury.

Conclusions: This study emphasizes that the ACS is an emergency medical situation, where prompt identification, workup and treatment should be done parallelly and urgently to prevent the morbidity and mortality.


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