Alcohol related Delirium in the ICU patients

Abstract-Background- Delirium, a concept of liaison Psychiatry is the highly prevalent form of acute cortical dysfunction seen in ICU settings. Patients with alcohol related delirium are associated with considerable burden in terms of morbidity and mortality due to prolonged hospitalization and cognitive impairment and can be prevented in most patients. Aim- To study the clinical profile of alcohol related delirium in the ICU patients in the background of their underlying illness and risk factors.Methods- The present study was conducted in the medical ICU at Government Stanley Hospital, involving 100 consecutive patients who fulfilled criteria for delirium under DSM4-TR.They were further assessed using Delirium rating scale Revised 98.Based on the history and presentation, patients were segregated as those with alcohol use disorder and those without alcohol use either in the present or past.Results- Of the 100 patients studied, 77 were males,23 females. No case of delirium with AUD among females. Patients presenting with delirium with alcohol use disorder were 66 while 34 patients had no history of alcohol. Delirium patients with AUD belonging to 20-40 years age (young) were 56.1,while 40-60 years (old) were 43.9.Among young alcohol users hyperactive delirium was81.1, hypoactive delirium-8.1,mixed type-10.8whereas hyperactive delirium was 46.4 ,hypoactive type-14.3,mixed type was 39.3 among old alcohol users. Illusions were common in both the age groups(43.2 42.9) compared to frank hallucinations (27.2,17.9).No significant difference in severity scores with respect to type of delirium among alcohol users. Conclusion- Early diagnosis of delirium in alcohol use disorder patients in the ICU and assessment of severity using validated scales and identification of the risk factors and perpetuating factors pave way for shorter ICU stays and decrease in morbidity and mortality in such high risk groups.