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The etiologies of altered level of consciousness in the emergency department

대한신경집중치료학회지 2020년 13권 2호 p.86 ~ 92
정수원, 전재천, 정창규, 조용원, 김근태,
소속 상세정보
정수원 ( Jung Su-Won ) - Keimyung University School of Medicine Department of Emergency Medicine
전재천 ( Jeon Jae-Cheon ) - Keimyung University School of Medicine Department of Emergency Medicine
정창규 ( Jung Chang-Gyu ) - Keimyung University School of Medicine Department of Internal Medicine
조용원 ( Cho Yong-Won ) - Keimyung University School of Medicine Department of Neurology
김근태 ( Kim Keun-Tae ) - Keimyung University School of Medicine Department of Neurology

Abstract


Background: New-onset altered level of consciousness (ALC) is a common condition in patients visiting the emergency department (ED). We evaluated the clinical characteristics, causes, and prognosis of adult patients presenting with ALC at an ED of a university hospital to determine the etiologies, outcomes, and destinations of these patients.

Methods: The medical records of patients with ALC who visited the ED of a university hospital from February 2019 to January 2020 were reviewed. The cause of ALC and its classification were carefully decided by agreement through a discussion among board-certified clinicians in emergency medicine, neurology, and internal medicine.

Results: Of the 731 patients with ALC in the ED, whose mean age was 68.81±16.40 years, most were in their 80s (198, 27.09%). The most common etiology of ALC was systemic infection (30.78%), followed by metabolic causes (21.07%) and stroke (18.19%). Extracerebral and intracerebral etiologies of ALC in the ED accounted for 51.85% and 26.68% of the cases, respectively. The overall mortality of ALC in the ED was 17.67%. The largest number of ALC cases of 443 patients, i.e., 60.6% of all ALC patients in the ED, visited within the time zone of 07:00?19:00.

Conclusion: This study identified the extra-cerebral etiologies as the major causes of ALC in the ED.

키워드

Consciousness disorders; Neurologic manifestations; Emergency medical services; Emergency medicine

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