Study of Delerium and Its Subtypes in Medically Ill Hospitalised Patients

Abstract

Introduction A multitude of terms are used to describe delirium, including encephalopathy, acute brain failure, acute confusional state and post-operative or intensive care unit psychosis, essentially it is defined as a relatively acute decline in cognitions that fluctuates over hours or days. There are two broad clinical categories have been described -hyperactive and hypoactive subtypes;that are based on differential psycho-motor features. A possible neuro-inflammatory basis for delirium is emerging and low levels of IGF-1 have recently been found as a risk factor for delirium. Acute phase reactant C-RP has been used as a marker of inflammation may also be implicated in the cause and outcome of delirium. Aims and Objectives 1) To study the prevalence of various subtypes of delirium in medically ill hospitalised patients. 2) To test C-RP as predictor of delirium and recovery from delirium as part of preliminary observational study. Methodology This is a cross-sectional study of descriptive and explorative design conducted at JSS Hospital, Mysore. A total of 113 patients were taken for the study and Patients who were admitted to ICU were assessed within 3 days of admission with 1) A standard bedside test of cognitive function, the MMSE(Mini Mental State Examination) 2) The Confusion Assessment Method(CAM) to determine the presence or absence of delirium. 3) The acute physiological score of APACHE-2,to measure the severity of acute physical illness. 4) Delirium Rating Scale. 5) C-RP was measured routinely along with other routine ICU investigations in all acute admissions. Results of the study The study is still being done in the hospital. Hence, the results will be presented during oral presentation in the conference.