The Clinical Analysis on the Altered Mental Status in the ED

Jin, Hon Chol; Roh, Jun Young; Cho, Suk Jin; Lee, Sang Rae; Kim, Sung Jun; Ryu, Seok Yong; Kim, Hong Yong

Abstract

PURPOSE
Altered mental status (AMS) is a collective phrase that describes an undifferentiated assortment of disorders of mentation including impaired cognition, attention, awareness, and level of consciousness. Although AMS is a common chief complaint and a frequent issue in the emergency department (ED), the clinical surveys of AMS have not been conducted in Korea. We analyzed the AMS patients on the clinical basis.
METHODS
From march 2002 to may 2002, we had enrolled prospectively 256 adult patients who visited the ED of Sanggye Paik Hospital because of AMS. The patients accompanied by AMS clinically were included, excluding patients caused by trauma, cerebrovascular accident with alert mentality. The clinical records were reviewed to analyze the clinical features of AMS, 9 months after discharge from ED.
RESULTS
AMS was found in 256 patients which comprised the 2.2% of the ED patients during the test period, and 112 patients were admitted. The most commonly encountered mental status was drowsiness(36.3%), and the overall mortality rate 10.2%. The AMS was caused by neurogenic, metabolic, alcohol-related, psychogenic disorders in frequency accounting for most of AMS etiologies.
CONCLUSION
This survey shows that the incidence of AMS is 2.2%, old age increases the rate of admission, and the common etiologies are neurogenic, metabolic, alcohol-related disorders. It seems prudent to approach the patients with AMS on the basis of etiologies and age.