World Journal of Emergency Medicine ›› 2012, Vol. 3 ›› Issue (4): 270-277.doi: 10.5847/wjem.j.issn.1920-8642.2012.04.006
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Hai-yu Xiao1, Yu-xuan Wang2, Teng-da Xu3(), Hua-dong Zhu3, Shu-bin Guo3, Zhong Wang3, Xue-zhong Yu3
Received:
2012-05-07
Accepted:
2012-10-27
Online:
2012-12-15
Published:
2012-12-15
Contact:
Teng-da Xu
E-mail:xutengda@yahoo.com.cn
Hai-yu Xiao, Yu-xuan Wang, Teng-da Xu, Hua-dong Zhu, Shu-bin Guo, Zhong Wang, Xue-zhong Yu. Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane[J]. World Journal of Emergency Medicine, 2012, 3(4): 270-277.
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URL: http://wjem.com.cn//EN/10.5847/wjem.j.issn.1920-8642.2012.04.006
Table 1
Disease profile for AMS patients in the emergency department
Clinical status | Number of patients (%) |
---|---|
Difficulties to arouse | 1 025 (53) |
Glasgow Coma Scale<15 | 851 (44) |
Disorientation for time, space and/or people | 696 (36) |
Diminished responsiveness to verbal or physical stimulation | 677 (35) |
Confusions | 522 (27) |
Unable to remain awake or conversant | 406 (21) |
Bizarre or inappropriate behavior | 174 (9) |
Hallucinations | 135 (7) |
Other | 58 (3) |
Table 2
Etiologic factors of AMS in different age groups (n=1 831)
Etiologic factors | Number of patients (%) | Age distribution n (%) | χ2 | P value | |
---|---|---|---|---|---|
Non-elderly <60 years | Elderly ≥60 years | ||||
Neurological causes | 641 (35.0) | 268 (24.9) | 373 (49.3) | 115.42 | <0.001 |
Cerebrovascular disease | 354 (19.3) | 80 (7.5) | 274 (36.2) | 236.93 | <0.001 |
Traumatic brain injury | 133 (7.3) | 84 (7.8) | 49 (6.5) | 1.20 | 0.274 |
Viral encephalitis | 73 (4.0) | 55 (5.1) | 18 (2.4) | 8.73 | 0.003 |
Seizures/epilepticus status | 65 (3.5) | 40 (3.7) | 25 (3.3) | 0.23 | 0.631 |
Intracranial tumors | 16 (0.87) | 9 (0.8) | 7 (0.9) | 0.04 | 0.844 |
Non-neurological causes | 1 190 (65.0) | 806 (75.1) | 384 (50.7) | 115.42 | <0.001 |
Pharmacologic & toxicologic? | 421 (23.0) | 375 (34.9) | 46 (6.1) | 208.58 | <0.001 |
Acute alcohol intoxication | 310 (16.9) | 303 (28.2) | 7 (0.9) | 235.09 | <0.001 |
Other factors | 111 (6.1) | 72 (6.7) | 39 (5.2) | 1.88 | 0.171 |
Systemic and organic dysfunction | 266 (14.5) | 119 (11.1) | 147 (19.4) | 24.87 | <0.001 |
Lung | 101 (5.5) | 29 (2.7) | 72 (9.5) | 39.52 | <0.001 |
Cardiovascular | 79 (4.3) | 41 (3.8) | 38 (5.1) | 1.56 | 0.212 |
Blood / immune | 36 (2.0) | 23 (2.1) | 13 (1.7) | 0.42 | 0.520 |
Kidney | 31 (1.7) | 13 (1.2) | 18 (2.4) | 3.64 | 0.057 |
Liver and gastrointestinal tract | 19 (1.0) | 11 (1.0) | 8 (1.1) | 0.01 | 0.946 |
Infectious factors?? | 167 (9.1) | 88 (8.2) | 79 (10.4) | 2.69 | 0.101 |
Metabolic / endocrine factors | 145 (7.9) | 97 (9.0) | 48 (6.3) | 4.41 | 0.036 |
Psychiatric problems | 71 (3.9) | 39 (3.6) | 32 (4.2) | 0.42 | 0.515 |
Multiple trauma | 38 (2.1) | 23 (2.1) | 15 (2.0) | 0.06 | 0.813 |
Gynecologic and obstetric | 35 (1.9) | 32 (3.0) | 3 (0.4) | 15.8 | <0.001 |
John Doe syndrome??? | 47 (2.6) | 33 (3.1) | 14 (1.8) | 2.66 | 0.103 |
Adrenal insufficiency | 13 (0.7) | 9 (0.8) | 4 (0.5) | 0.60 | 0.437 |
Limbic encephalitis | 6 (0.3) | 5 (0.5) | 1 (0.1) | —— | —— |
Koyanagi-Harada syndrome | 3 (0.2) | 3 (0.3) | 0 | —— | —— |
Anti-NMDA receptor encephalitis | 1 (0.1) | 1 (0.1) | 0 | —— | —— |
Other | 24 (1.4) | 15 (1.4) | 9 (1.2) | 0.15 | 0.700 |
Total | 1 831 | 1 074 | 757 |
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