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

<p><strong>Aims and objectives: </strong>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.</p> <p><strong>Methodology</strong>: 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.</p> <p><strong>Results: </strong>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).</p> <p><strong>Conclusion:</strong> 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.</p>