Clinical profile and mortality among adult patients presenting with altered mental status to the emergency departments of a tertiary hospital in Tanzania: a descriptive cohort study.

Journal: The Pan African medical journal

Volume: 41

Issue: 

Year of Publication: 2022

Affiliated Institutions:  Emergency Medicine Department, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania. The Aga Khan Hospital, Dar es Salaam, Tanzania. Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.

Abstract summary 

Altered mental status (AMS) in the Emergency Department (ED) can be associated with morbidity and mortality. In high income countries, mortality rate is under 10% for patients presenting with AMS. There is a paucity of data on the profile and mortality amongst this group of patients in limited income countries.this was a prospective cohort study of adults ≥18 years presenting to the Emergency Departments of Muhimbili National Hospital (MNH) Upanga and Mloganzila in Tanzania with Altered Mental Status (AMS) unrelated to psychiatric illness or trauma, from August 2019 to February 2020. Patient demographic data, clinical profile, disposition and 7-day outcome were recorded. The outcome of mortality was summarized using descriptive statistics.among 26,125 patients presenting during the study period, 2,311 (8.9%) patients had AMS and after exclusion for trauma and psychiatric etiology, 226 (9.8%) patients were included. The median age was 56 years (43-69 years) and 127 (56.2%) were male. Confusion 88 (38.9%) was the most common presenting symptom. Hypertension 121 (53.5%) was the most frequent associated comorbidity. The overall mortality was 80 (35.4%) within 7 days. Of 173 patients admitted to the wards, 54 (31.2%) died and of the 46 (20.4%) admitted to the intensive care unit (ICU), 20 (43.5%) died within 7 days. Six (2.7%) patients died in the emergency department.patients with AMS presenting to two EDs in Tanzania have substantially higher mortality than reported from Hospital Incident Command System (HICS). This could be due to underlying disease, comorbidities or management. Further research could help identify individual etiologies involved and high risk groups which can cater to better understanding this population.

Authors & Co-authors:  Manji Hussein Karim HK Sawe Hendry Robert HR Kilindimo Said S Premji Elishah Nuralah EN Yussuf Amne Omar AO Simbila Alphonce Nsabi AN Versi Sabira Akber SA Weber Ellen Joyce EJ

Study Outcome 

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Statistics
Citations :  Douglas VC, Josephson SA. Altered mental status. Continuum (Minneap Minn) 2011 Oct;17(5 Neurologic Consultation in the Hospital):967–83.
Authors :  8
Identifiers
Doi : 46
SSN : 1937-8688
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Altered mental status;Tanzania;emergency department;sub-Saharan Africa
Study Design
Cohort Study,Descriptive Study
Study Approach
Country of Study
Tanzania
Publication Country
Uganda