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STRUCTURE OF MORBIDITY AND MORTALITY AMONG PATIENTS WITH ALTERED STATE OF CONSCIOUSNESS (ASOC) ADMITTED IN MEDICAL WARD 6 OF DHQ/TEACHING HOSPITAL, GUJRANWALA

Dr. Shaza Khawar, Dr. Farva Farooq, Dr. Muhammad Nabeel Shafqat

Background: Though defined as a change in intellectual, emotional, psychological, and personality functioning, typically accompanied by behavioral changes, altered state of consciousness (ASOC) refers to a group of non-specific and variable neurological symptoms, either hyper-active or hypo-active, assessed by the Glasgow Coma Scale (GCS), and be psychiatric, encephalitic, or intracranial in cause. The diagnoses this leads to fall in various categories: pharmacological, systemic/organic, obstetric, metabolic, endocrine, and so on. Demographic data among patients with ASOC can help identify disease trends and, in turn, can make way for effective planning of better healthcare services to cater to one of the most frequently encountered complaints in emergency departments. Objective: The aim of our study was to assess the morbidity and mortality among patients admitted with the chief presenting complaint of ASOC in Medical Ward 6 of DHQ/Teaching Hospital, Gujranwala. Materials and Methods: This is a descriptive cross-sectional study, performed on 1095 patients, out of which 417 (38.08%) presented with the chief complaint of ASOC, and were admitted in Medical Ward 6 between February 2018 and July 2018, chosen by the convenient sampling technique. Data regarding the demographic features of these patients along with their diagnoses, whether malignant or non-malignant, and involving which system and their clinical outcomes were collected via structured performas and analyzed. Results: Out of a total of 417 (38.08%) patients, 241 (57.8%) were females while 176 (42.2%) were males. The mean age with standard deviation was 63.7 ± 16.2 years. Total duration (SD) of hospital stay was 4.01 (± 3.64 days). HTN and DM were the commonest co-morbid conditions found in 199 (47.7%) and 157 (37.7%) patients respectively. Other common co-morbidities were CLD 149; 35.7%), stroke 77; 18.5%), and CKD (38; 9.1%). The commonest diagnoses turned out to be CVA (16.2%), closely followed by DCLD due to PSE (13.7%). 156. (37.4%) of these patients expired during hospital stay. Conclusion: Prognosis of patients presenting with ASOC is strikingly poor with high in-hospital mortality rates. Keywords: ASOC, morbidity, mortality, DHQ/Teaching Hospital, Gujranwala.

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