Abstract

Acute encephalopathies or acute confusional states are among the commonest causes of hospital admissions especially among the elderly population. A treating physician needs to have a thorough knowledge of the various etiologies, clinical presentations and associations of acute encephalopathy in order to manage these patients in a timely and efficient manner. The present study was a prospective cross sectional study conducted over a period of one year aimed to know the dynamics of encephalopathy patients attending the medical emergency. Patients who met the inclusion and exclusion criteria were included after taking consent from the attendants. The mean age of the patients was 60 years for males and 61.8 years for females. About 19.7% patients admitted in emergency department had acute confusional state. The most common etiologies in the study were strokes (25.6%), metabolic (24.9%) and septic (18.5%) encephalopathies followed by seizures (13%) and intracranial infections (5%). About 35.5% cases had multiples factors responsible for encephalopathy. The most frequent symptoms besides encephalopathy included weakness on one side of the body (15.8 %), headache (14.1%), cough (12.6%), incontinence (10.7), breathlessness (10.1%) and fever (10.2%). The overall mortality in the study was 16.5%. Mortality was significantly higher in patients with weak or non-palpable pulses, hypotensive patients, patients with aberrant pupillary responses, patients admitted in winter period and obese patients. Also low mean arterial PH, oxygen saturation and mean diastolic BP and high total leukocyte count and potassium were significantly associated with mortality.

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