Clinical Profile of Patients Presenting with Altered Sensorium to Emergency Department

Abstract

Altered sensorium is a frequent presentation in emergency department, but the exact etiology of many altered sensorium patients is unknown. Patients present with vague symptoms, thus altered sensorium diagnosis and treatment are highly challenging for emergency physicians. The aim of this study is to provide a framework for the assessment of altered sensorium patients. This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management. This is a retrospective record based study. The research duration was from January, 2016 to December 31, 2016. The study involved 9,800 emergency patients, in which 524 (5.34%) were altered sensorium patients. Demographic characteristics, clinical manifestations, assessment approaches, causative factors, emergency treatments and outcomes were collected. In 524 patients with altered sensorium patients recruited, accounting for 5.34% of all emergency department patients, 316 (60%) were male, and 208 (40%) female. Etiologic factors were neurological (n=225; 42.93%) & nonneurological (n=299; 57.07%). Patients with altered sensorium pose a diagnosing difficulty for ED physicians. The most frequently encountered diagnostic categories causing altered sensorium patients were primary CNS disorders, intoxication, organ system dysfunction, and endocrine/metabolic diseases. Altered sensorium is an important warning signal for ED patients because of its potentially fatal and reversible effects. Prompt evaluation and treatment are essential to decrease morbidity and mortality associated with altered sensorium patients.