Aetiology and Short-term Outcome of Altered Level of Consciousness among Patients in Medicine Department of a Tertiary Hospital

Background: Altered level of consciousness is a very common medical emergency resulting in considerable mortality & morbidity. Accurate diagnosis & prompt management can reduce the complications to a great extent. There are various aetiologies of impaired consciousness including infective &a...

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Published inJournal of medicine Vol. 18; no. 2; pp. 80 - 85
Main Authors Sarker, Partha Sarathi, Rahman, Md Saidur, Biswas, Palash Kumar, Chowdhury, Md Monjurul Kader, Chowdhury, Md Muntasir Islam, Karmaker, Madhabi, Azad, Khan Abul Kalam
Format Journal Article
LanguageEnglish
Published Dhaka Bangladesh Society of Medicine 24.08.2017
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Abstract Background: Altered level of consciousness is a very common medical emergency resulting in considerable mortality & morbidity. Accurate diagnosis & prompt management can reduce the complications to a great extent. There are various aetiologies of impaired consciousness including infective & metabolic causes as well as cerebrovascular accidents. This study described clinical outcomes of the patients relating to specific aetiologies of the illness.Objectives: To explore the common aetiologies of altered consciousness & to determine the clinical outcomes of the patients after one month in a tertiary level hospital of Bangladesh.Methods: This hospital based prospective observational study was conducted in Medicine department of Dhaka Medical College Hospital (DMCH) from December 2013 to May 2014. Sample size was 100 & the data was collected by structured questionnaire. Purposive sampling method was applied using inclusion & exclusion criteria. Statistical analysis of the result was obtained by using SPSS-16.Results: The mean age of the study patients was found 48.7 years with range from 19-92 years. Majority (58%) of the patients were male. Stroke was identified as the commonest (39%) aetiology of impaired consciousness followed by meningo-encephalitis (19%), septicemia (10%) & poisoning (10%). Among metabolic encephalopathy diabetic ketoacidosis was 3%, hypoglycemia 1% and hepatic, uremic & hypertensive encephalopathy was 3%, 4% & 1% respectively. Overall death rate was higher among patients with stroke (26%), ICSOL (50%), ADEM (50%) than those with meningoencephalitis (5.3%), septicemia (20%) & poisoning (10%).Conclusion: Infective & metabolic causes of impaired consciousness showed better outcome than structural & vascular aetiologies of brain.J MEDICINE July 2017; 18 (2) : 80-85
AbstractList Background: Altered level of consciousness is a very common medical emergency resulting in considerable mortality & morbidity. Accurate diagnosis & prompt management can reduce the complications to a great extent. There are various aetiologies of impaired consciousness including infective & metabolic causes as well as cerebrovascular accidents. This study described clinical outcomes of the patients relating to specific aetiologies of the illness.Objectives: To explore the common aetiologies of altered consciousness & to determine the clinical outcomes of the patients after one month in a tertiary level hospital of Bangladesh.Methods: This hospital based prospective observational study was conducted in Medicine department of Dhaka Medical College Hospital (DMCH) from December 2013 to May 2014. Sample size was 100 & the data was collected by structured questionnaire. Purposive sampling method was applied using inclusion & exclusion criteria. Statistical analysis of the result was obtained by using SPSS-16.Results: The mean age of the study patients was found 48.7 years with range from 19-92 years. Majority (58%) of the patients were male. Stroke was identified as the commonest (39%) aetiology of impaired consciousness followed by meningo-encephalitis (19%), septicemia (10%) & poisoning (10%). Among metabolic encephalopathy diabetic ketoacidosis was 3%, hypoglycemia 1% and hepatic, uremic & hypertensive encephalopathy was 3%, 4% & 1% respectively. Overall death rate was higher among patients with stroke (26%), ICSOL (50%), ADEM (50%) than those with meningoencephalitis (5.3%), septicemia (20%) & poisoning (10%).Conclusion: Infective & metabolic causes of impaired consciousness showed better outcome than structural & vascular aetiologies of brain.J MEDICINE July 2017; 18 (2) : 80-85
Background: Altered level of consciousness is a very common medical emergency resulting in considerable mortality & morbidity. Accurate diagnosis & prompt management can reduce the complications to a great extent. There are various aetiologies of impaired consciousness including infective & metabolic causes as well as cerebrovascular accidents. This study described clinical outcomes of the patients relating to specific aetiologies of the illness. Objectives: To explore the common aetiologies of altered consciousness & to determine the clinical outcomes of the patients after one month in a tertiary level hospital of Bangladesh. Methods: This hospital based prospective observational study was conducted in Medicine department of Dhaka Medical College Hospital (DMCH) from December 2013 to May 2014. Sample size was 100 & the data was collected by structured questionnaire. Purposive sampling method was applied using inclusion & exclusion criteria. Statistical analysis of the result was obtained by using SPSS-16. Results: The mean age of the study patients was found 48.7 years with range from 19-92 years. Majority (58%) of the patients were male. Stroke was identified as the commonest (39%) aetiology of impaired consciousness followed by meningo-encephalitis (19%), septicemia (10%) & poisoning (10%). Among metabolic encephalopathy diabetic ketoacidosis was 3%, hypoglycemia 1% and hepatic, uremic & hypertensive encephalopathy was 3%, 4% & 1% respectively. Overall death rate was higher among patients with stroke (26%), ICSOL (50%), ADEM (50%) than those with meningoencephalitis (5.3%), septicemia (20%) & poisoning (10%). Conclusion: Infective & metabolic causes of impaired consciousness showed better outcome than structural & vascular aetiologies of brain.
Author Biswas, Palash Kumar
Karmaker, Madhabi
Sarker, Partha Sarathi
Chowdhury, Md Monjurul Kader
Chowdhury, Md Muntasir Islam
Rahman, Md Saidur
Azad, Khan Abul Kalam
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SubjectTerms Clinical outcomes
Consciousness
Encephalitis
Hospitals
Meningitis
Metabolism
Poisoning
Sepsis
Title Aetiology and Short-term Outcome of Altered Level of Consciousness among Patients in Medicine Department of a Tertiary Hospital
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