Speakers - 2026

Title: A study of clinical profile and outcomes of patients presenting with altered sensorium in tertiary care emergency and ICU settings

Abstract

Introduction:
Altered sensorium is a common and serious emergency presentation involving impaired consciousness, awareness, or cognition. Understanding the clinical profile and etiologies in tertiary care settings helps predict outcomes and guide timely interventions.

Objectives:
1. To describe the clinical profile and underlying causes of altered sensorium.
2. To assess short term outcomes and examine the association between specific etiologies and patient prognosis.

Material And Methods:
A single center prospective observational study was conducted over six months, including 54 adults (Above 20 years) presenting with altered sensorium of varied etiologies.

Results:
The cross sectional observational study showed slight male predominance (59.3%), with elderly patients (Above 60 years) forming the largest group (42.6%). Most participants were housewives (38.9%) and farmers (33.3%), reflecting the rural population served. Over half of the patients (51.8%) presented with severe impairment. Lethargy (46.3%) and coma (27.8%) were the predominant clinical states.

Metabolic causes were the most frequent etiologies and demonstrated excellent outcomes, with a 90.6% recovery rate and 9.4% mortality likely due to reversibility (e.g., hypernatremia, uremia). Cerebrovascular accidents (20.4%), mostly ischemic strokes (14.8%), showed high mortality (54.5%). Infection related etiologies accounted for 11.1% and carried the highest mortality (66.7%), especially septic encephalopathy.

Conclusion:
The study highlights the significant burden of altered sensorium in emergency settings, with an overall mortality of 24.1%. Metabolic etiologies, though common, have favourable outcomes, whereas cerebrovascular and infectious causes exhibit markedly high mortality. Advanced age and low GCS at presentation emerged as strong predictors of short term mortality.These findings underscore the critical need for prompt investigation and targeted intervention based on identified etiology to improve outcomes, particularly in elderly patients presenting with severe altered sensorium due to stroke or sepsis.