Severity, etiology, and outcome of delirium in indoor patients referred to consultation-liaison psychiatry

Abstract

Background: Delirium is a complex neuropsychiatric syndrome characterized by an acute decline in the level of consciousness, cognition, and impairment in attention, with adverse physical, cognitive, and psychological outcomes. Aims: This study aimed to assess the severity, etiology, and outcome of delirium in indoor patients referred to consultation-liaison psychiatry. Settings and Design: A prospective observational study was conducted on 200 indoor patients diagnosed with delirium at a tertiary care hospital in Gujarat, India. Materials and Methods: The Delirium Rating Scale-Revised-98 (DRS-R-98) was used for the severity and delirium etiological checklist for the cause of delirium. Statistical Analysis Used: Data were entered in an Excel sheet and analyzed with Epi Info. Continuous variables were expressed as mean and standard deviation while categorical variables were expressed as percentages. The association between categorical variables was tested with a Chi-square test. P < 0.05 was considered statistically significant. Results: As per the DRS-R-98 score, 45.4%, 38%, and 16.5% of patients had less severe, severe, and nonsevere delirium, respectively. The most common etiology was metabolic and endocrine disturbances (66.5%) followed by systemic infection (41.5%), drug withdrawal (38.5%), and organ insufficiency (31.5%). The mean duration of the delirium episode was 3.7 days and length of the hospital stay was 8.6 days. Delirium was reversible in 91% and irreversible in 9% of patients and mortality was 9%. Conclusions: Delirium is reported commonly in middle-aged males. Metabolic and endocrine disturbances, systemic infection, and drug withdrawal are common causes of delirium. Delirium severity is related to a longer hospital stay, a low discharge rate, and higher mortality.