Comparative Study of Delirium Associated with Alcohol Withdrawal Versus Other Medical Illnesses: Clinical Profile, Course of Illness & Outcome
Abstract:
Background: Alcohol withdrawal and other medical conditions are among the many etiologies of delirium, a common and dangerous condition seen in the medical intensive care unit (MICU). There hasn't been much study done to compare the clinical characteristics, progression of the illness, and prognoses of these various delirium subtypes. In addition to determining the etiology of delirium and the clinical profile of patients admitted to a tertiary care hospital's medical intensive care unit, this study also attempts to determine the relationship between psychotic symptoms and cognitive status.
Methods: In a tertiary care hospital, 152 participants were admitted for the study. Four scales—the delirium rating scale-r-98, the cognitive test for delirium, the brief psychiatric rating scale (BPRS), and the delirium etiology checklist—were used to evaluate the symptoms, progression of the illness, and results. Both the Kuppuswamy scale and the Severity of Alcohol Dependence Questionnaire (SADQ)
Results: Preliminary findings revealed a diverse clinical profile and course of delirium among the subjects with various medical illnesses. Predisposing factors, such as advanced age and pre-existing cognitive impairment, were identified, along with precipitating factors such as infections and medication use. Delirium subtypes included hypoactive, hyperactive, and mixed presentations. Cognitive impairment and psychotic symptoms were observed to varying degrees among delirious patients. The BPRS, Delirium Rating Scale-Revised-98, MMSE, and Delirium Etiology Checklist provided valuable insights into the severity, etiology, and symptomatology of delirium. The correlation analysis revealed a significant association between cognitive impairment and the presence of psychotic symptoms in delirium.
Conclusion: This study sheds light on the clinical profile, course, and outcomes of delirium in patients admitted to the tertiary care centre. The identification of predisposing and precipitating factors contributes to the understanding of delirium etiology. The recognition of different delirium subtypes highlights the importance of tailored management approaches. The correlation between cognitive status and psychotic symptoms underscores the complex nature of delirium. The scales utilized in this study proved to be effective tools for evaluating delirium severity, symptomatology, and etiology. Further research is necessary to explore interventions aimed at improving outcomes and reducing the burden of delirium in the MICU setting. The results point to the significance of understanding the distinct characteristics and progressions of every kind of delirium in order to provide the proper care and interventions in the MICU.
