Altered Mental Status: Diagnostic value of various clinical parameters and diagnostic accuracy in emergency department (original) (raw)

Background: Evaluation of a patient with Altered Mental Status AMS in the Emergency department ED is difficult for many reasons. Emergency physician is usually expected to make q a correct working provisional diagnosis in AMS in quick time; and the accuracy of this provisional diagnosis has an important bearing sometimes on prognosis of patient Objective: The Aim of the study was to determine retrospectively the diagnostic accuracy in the Emergency Department and to determine diagnostic value of various components of clinical evaluation. Methods: The study was conducted prospectively in 201 patients who presented to a tertiary care hospital with AMS .Children, and patients with history of dementia, psychiatric disease, were excluded. History and examination was done, and provisional diagnosis made. CT scan head & CSF analysis were routinely done. All required investigations were done to reach the final diagnosis. Results: In 11.4% provisional diagnosis did not match with final diagnosis, in 16.4%, diagnosis matched partially, in 71.6 % diagnosis matched completely. The specific features of the clinical evaluation of diagnostic value followed by rates of positive diagnostic finding included: