European Journal of Molecular & Clinical Medicine

BACKGROUND: The assessment of patients presenting with altered mental status (AMS) in the emergency department (ED) is challenging as these patients are characterized by a broad spectrum of illnesses and disease severity. The present study is to determine the etiology and outcome as well as the role of the GCS score as a prognostic value.
 METHODS: This prospective observational study was done in a tertiary care center, in India over a period of two years where patients with AMS were evaluated and subjected to relevant investigations. All available clinical and laboratory data were used to ascertain the cause of the altered sensorium. Patients were followed up until discharge or death.
RESULTS: Among 1000 study participants 57% were males with a mean age of 52.5years. The most common etiology was Metabolic Encephalopathy (32%) followed by poisoning (20%). Mortality was highest in Cerebrovascular accidents (84.4%) and partial recovery was highest in Neuro-infection. Glasgow Coma Scale score <6 was associated with mortality of 44.4%.
CONCLUSION: AMS is a vital warning signal, because of its potentially fatal and irreversible effects. Timely evaluation with the point of care investigation reduces mortality in metabolic and poisoning causes and greatly improves the cost-effective basis for treatment.