Evaluation of Patients with Delirium in the Emergency Department

Year 2012, , 381 - 385, 01.04.2012

Latif Duran Dursun Aygün

https://doi.org/10.5152/balkanmedj.2012.023

Abstract

Objective: Delirium is a neuropsychiatric syndrome characterized by acute onset and a fluctuating course of globally altered mental status. It has been reported that the frequency of delirium among patients hospitalized with any disorder ranges from 2 to 30%. However, in the literature, few studies have evaluated the frequency of delirium in hospitalized patients, including those older than 65 years. According to our knowledge, this is the first study on adult patients in all age groups in an emergency department. We aimed to classify delirium according to its etiological causes and to compare the age groups for frequency and these causes. Material and Methods: Forty-three patients were included in the study; they had been diagnosed with delirium according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV in an emergency department from December 2002 to December 2003. The patients were divided into two groups (group I: age <65 years, group II: age ≥65 years). Following a detailed history, each patient underwent a physical and neurological examination. Additionally, the Mini-Mental State Examination was administered. Radiological and hematological examinations were conducted on all patients who had indications for such testing. Results: Of the patients with delirium, 18 were female and 25 were male. Mean age was 61.18 years (range 18 to 90 years). Of the 43 patients, 21 were in group I and 22 were in group II. The most common causes of delirium were metabolic disorders. There was no significant difference between group I and II for the frequency or etiological causes of delirium. Conclusion: In emergency departments, all patients with delirium should be evaluated for etiological factors, especially metabolic disorders, as treatment of the underlying cause is essential in delirium. Turkish Başlık: Acil Serviste Deliryumlu Hastaların Değerlendirilmesi Anahtar Kelimeler: Acil Servis, Deliryum, Etyoloji,Yaş grupları Amaç: Deliryum, akut olarak başlayan ve dalgalı bir seyir gösteren global mental durum değişikliği ile karakterize nöropsikiyatrik bir sendromdur. Herhangi bir hastalık nedeni ile hastanede yatırılan hastalar arasında ki deliryum sıklığının % 2 ile 30 arasında olduğu bildirilmiştir. Bununla birlikte, literatürde 65 yaş ve üzeri yatan hastalarda deliryum sıkılığını değerlendiren sadece birkaç çalışma vardır. Bizim bilgilerimize göre bu çalışma, acil serviste deliriyumlu erişkin hastalarda tüm yaş gruplarını içeren ilk çalışmadır. Bu çalışmada, deliryumun etyolojik nedenlerine göre sınıflandırılması, yaş gruplarının etiyolojik nedenler ve sıklık açısından karşılaştırılması amaçlandı. Materyal Metod: Aralık 2002-2003 tarihleri arasında, Mental Bozuklukların Tanısal ve Sayımsal El kitabı – IV (DSM-IV) kriterlerine göre acil serviste deliryum tanısı alan 43 hasta çalışmaya dâhil edildi. Hastalar iki gruba ayrıldı (Grup I: yaş >65yıl ve Grup II: yaş ≤65yıl). Detaylı bir anamnezi takiben, her hastanın fizik ve nörolojik muayenesi yapıldı. Buna ek olarak Mini Mental Durum Değerlendirme Skalası uygulandı. Endikasyonu olan tüm hastalara radyolojik ve hematolojik incelemeler yapıldı. Bulgular: Deliryumlu hastaların 18 kadın ve 25 erkekti. Ortalama yaş 61.18 ±18 idi. 43 hastanın 21 tanesi Grup I'de, 22 tanesi Grup II'de idi. Deliryumun en sık nedeni metabolik bozuklukları idi. Grup I ve Grup II arasında deliryumun etyolojik faktörleri veya sıklığı açısından fark yoktu. Sonuç: Acil servislerde deliryumlu hastalar etyolojik faktörler ve özellikle de metabolik bozukluklar açısından değerlendirilmelidir. Çünkü deliryum için altta yatan sebebin tedavisi esastır.

Keywords

Emergency department, delirium, etiology, age groups

Evaluation of Patients with Delirium in the Emergency Department

Abstract

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