Etiolog?as asociadas a estado de alteraci?n de la conciencia en pacientes atendidos en sala de emergencia del Hospital General Plaza de la Salud, durante el per?odo enero-diciembre 2022

Abstract

[Espa?ol] El estado alterado de la conciencia (ALC) se refiere al cambio o deterioro de atenci?n, excitaci?n o vigilia que no es causado por un estado de somnolencia fisiol?gico. Al menos 1 de cada 10 pacientes en sala de emergencia y 1 de cada 4 pacientes hospitalizados presentan cl?nica ALC en el momento del ingreso y en ocasiones el personal de emergencia no logra reconocer. Este trabajo es un estudio descriptivo de tipo retrospectivo y corte transversal con el objetivo de determinar la etiolog?a m?s frecuente asociada ALC en pacientes admitidos en sala de emergencia del Hospital General Plaza de la Salud durante el a?o 2022. Se complet? un formulario con informaci?n de 138 expedientes cl?nicos y se tom? el diagn?stico principal dado por el especialista de emergencia e interconsultante como criterio para describir la etiolog?a de ALC y que conduzca a la disposici?n final del paciente desde la sala de emergencia. Se determin? que la etiolog?a m?s frecuente a ALC fue asociada a las infecciones sist?micas (neumon?a, sepsis y shock s?ptico) con 23.9% (32/138), afectando principalmente a la poblaci?n mayor de 66 a?os sin distinci?n de sexo. El 60.8% (84/138) de los pacientes recibieron una atenci?n sanitaria previa a su llegada a sala de emergencia y el 72% (99/138) de los mismos ten?an una escala de Glasgow entre 15-13 puntos en lo que se valoraba un nivel let?rgico en la mayor?a de los casos. El 40.58% (56/138) de los pacientes se ingresaron a sala cl?nica y se tuvo una mortalidad de un 4%.

[English] An altered state of consciousness (ALC) refers to the change or impairment of attention, arousal, or wakefulness that is not caused by physiological sleepiness. At least 1 in 10 patients in the emergency room and 1 in 4 hospitalized patients have ALC symptoms at the time of admission and sometimes emergency personnel fail to recognize them. This work is a retrospective and cross-sectional descriptive study to determine the most frequent etiology associated with ALC in patients admitted to the emergency room of the Plaza de la Salud General Hospital during the year 2022. A form was completed with information from 138 clinical records and the main diagnosis given by the emergency specialist and inter-consultant was taken as a criterion to describe the etiology of ALC and to lead to the final disposition of the patient from the emergency room. It was determined that the most frequent etiology of ALC was associated with systemic infections (pneumonia, sepsis, and septic shock) with 23.9% (32/138), mainly affecting the population over 66 years of age without distinction of sex. 60.8% (84/138) of patients received health care before arrival in the emergency room and 72% (99/138) of them had a Glasgow scale between 15-13 points in what was assessed as lethargic in most cases. 40.58% (56/138) of the patients were admitted to the clinical ward and had a mortality of 4%.