A Study of prevalence and determinants of delirium in a tertiary care hospital

Aims and objectives To assess the prevalence types and course of delirium in Sri ManakulaVinayagar Medical College Hospital a tertiary care teaching hospital in Puducherry. The factors associated with delirium from demographic to possible determinants were also analyzed.Methodology Convenience sampling method was used for this study. Consecutive patients admitted to either psychiatry ward or any other medical or surgical wards fulfilling the inclusion and exclusion criteria were selected for the study. Diagnosis of delirium was ascertained by Confusion Assessment 13 14 Method CAM first its severity by Delirium Rating Scale DRS daily till recovery or death and Motor sub-typing subscale of Memorial Delirium Assessment 15 Scale MDAS for classifying delirium based on motor activity.Results Of the 36 cases studied 28 were males 77 and 8 females 23. The age ranged from 45 years to 82 years. Delirium accounted for 4.7 of cases seen by psychiatrists during the study period. Major determinants associated with delirium were alcohol withdrawal 47 major trauma 16 and sepsis 11. Electrolyte imbalance Hyponatremia and Hypokalemia were found in almost 70 of the cases. Hyperactive 44 type was more common followed by mixed 33 and hypoactive 22 at the initial presentation. Recovery was complete in 95 of cases with an average of 8 days whereas 2 patients expired Major Trauma ndash Head injury Sepsis.Conclusion Multiple factors were found in any case of delirium. Alcohol withdrawal was noted in a significant number of cases and they were mostly hyperactive in nature.