[Three-month life prognosis and associated factors in patients with altered mental status admimtted to the emergency room of a national hospital in Peru]

Rev Peru Med Exp Salud Publica. 2014 Jul-Sep;31(3):480-6.
[Article in Spanish]

Abstract

Objectives: Determine the prognosis at three months and associated factors of patients with altered mental status (AMS).

Materials and methods: Cross-sectional study that included patients over 18 years of age admitted to the emergency room in a national hospital, with AMS, within twenty-four hours of onset and that required observation. The demographic, clinical and functional assessment information were taken from the medical record. A follow-up was made at three months by telephone.

Results: The study included 290 patients, representing 4.1% of the total patients in the emergency room. Overall mortality was 24.2%, whereas in the subgroup of older adults was 28.1%; 19.3% in adults and 15.2% in young adults. The average age was 63.5 years and the elderly group constituted nearly two thirds of the population. 51% were males. The average hospital stay was 7 days. The most frequently associated causes were infectious diseases (44.1%), neurological (40.3%), respiratory (28.3%), metabolic (18.6%), and cardiovascular (17.2%) disorders. Mortality was associated with a) GCS levels <7 (OR 2.9, p<0.001) and b) functionality score of 5 on the modifi Rankin scale (OR 8.2, p=0.03).

Conclusions: AMS, present in 4% of emergency admissions, is associated with mortality in one in four people. The predominant cause infectious diseases. The commitment of the functionality was the main predictor of mortality.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Female
  • Hospitals
  • Humans
  • Male
  • Mental Disorders / mortality*
  • Middle Aged
  • Patient Admission
  • Peru
  • Prognosis
  • Time Factors
  • Young Adult