Acute confusional state in hospitalised older adults; a preliminary study of the causes and associated factors

Introduction: Acute confusional state is common among hospitalized elderly. It causes considerable expenses to the healthcare system and distress to the patients and caregivers. Identification of causes of acute confusional state can facilitate its timely and optimal management, thereby reducing its adverse consequences. The objectives of this study were to determine the causes and associations of acute confusional state among hospitalised older adults in Teaching Hospital, Karapitiya. Methods: A cross-sectional study was conducted among 105 patients, aged 50 years or more, with acute confusional state admitted to Teaching Hospital, Karapitiya. An interviewer-administered questionnaire was used to collect data from patients and other relevant data were extracted from patients' records. Chi-square test was used to assess the association between variables. Results: Mean (SD) age of the sample was 70.9 (6.5) years, with nearly equal numbers of males and females. Approximately 37% had some chronic disease. Cerebral causes accounted for 52.4% of the cases of acute confusional state, including meningitis (14.3%), intra-cerebral haemorrhage (10.5%) and cerebellar infarction (9.5%). Common non-cerebral causes included urinary tract infections (15.2%) and hepatic encephalopathy (8.6%). Majority (59%) required inward care for 1-2 weeks. There was no significant difference between the proportion of cerebral and non-cerebral causes. Acute confusional state due to cerebral causes was associated with prolonged hospital stay (p<0.01).