European Journal of Cardiovascular Medicine

Background: Diagnosis and delay in management of encephalopathy in elderly patients is challenging due to the paucity of presenting symptoms and signs. Objectives: To assess theetiologies, clinical profile, and outcome of encephalopathy in elderly. Method: This was a prospective observational study conducted over a period of two year (November 2020 to October 2022) on all elderly patients presenting with encephalopathy.Their demographic profile along with clinical presentation, laboratory, imaging results and outcome were recorded and analysed.Results: Majority of patients belonging to age group of 60-70 years (41.5%), with males’ predominance (59.9%). Maximum 56(39.4%) patients had 7-12 hours of altered mental status, (p<0.00001).47.2% presented with fever. Most patients had raised blood pressure (45.07%), neurological abnormalities (motor weakness) (27.4%), GCS score of 6-10 (57.7%), respiratory findings(47.8%). 29.5%had hyponatremia, 22.5%hypocalcaemia and 22.5% hypokalaemia. Higher number ofpatients had CT/MRI brain findings suggestive of haemorrhage and infarction. Most of the patients had ECG abnormalities in form of atrial fibrillation (11.2%). Etiology of encephalopathy in elderly was most commonly due to neurological causes (37.3%). Out of 142 patients, 64.8% were survivors and 35.2% was non-survivors.Most common cause of death were neurological (cerebro-vascular episode) followed by infections (meningitis). Patients who presented late or with more duration of altered mental status has more mortality than patients who presented early signifying that early diagnosis and treatment can reduce mortality significantly. Patients who presented with low GCS has higher mortality then patients with higher GCS. Conclusion: Elderly patients present late with paucity of symptom and signs. Hence, early presentation, early diagnosis and treatment will facilitate better outcome.