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Colegio de Medicina Interna de México.

2025, Number 08

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Med Int Mex 2025; 41 (08)

Acute confusional syndrome as a clinical marker of mortality in hospitalized patients

Gámez DJR, Salas PAC, Armenta PD, López DE, Navarro BG, Maggiani AP

Language: Spanish
References: 15
Page: 478-486
PDF size: 189.17 Kb.


ABSTRACT

Objective: To evaluate the association between acute confusional syndrome (ACS) and mortality in hospitalized patients, and to determine whether ACS is an independent predictor of mortality.
Materials and Methods: This observational, prospective, analytical study was conducted from November 2023 to January 2025 on patients treated at the General Hospital of Mazatlán. Hospitalized adults were included and divided into two groups: those with and without acute confusional syndrome. The primary outcome was 14-day mortality. Multivariate logistic regression, adjusted for clinical variables, was applied to analyze the data.
Results: Of the 1324 patients, 18.1% had acute confusional syndrome (ACS), and they were older (59.1 ± 18 years vs 51.1 ± 21 years, p ‹ 0.01). They also experienced more episodes of neuroinfection (2.9% vs 0.3%, p ‹ 0.01), acute coronary syndrome (10.8% compared to 3.7%; p ‹ 0.01), hypertensive emergency (8.3% compared to 3.5%; p ‹ 0.01), septic shock (8.3% compared to 3.4%; p ‹ 0.01), and cerebrovascular events (16.6% compared to 3.1%; p ‹ 0.01). Mortality was higher in the (+) group (28.7% versus 13.8%; p ‹ 0.01). In the multivariate analysis, acute confusional syndrome (ACS) increased the risk of death (odds ratio [OR] 1.13; 95% confidence interval [CI]: 1.07- 1.18; p ‹ 0.01) and was accentuated by septic shock (OR 1.52; 95% CI: 1.24-1.87; p ‹ 0.01). Hypertensive urgency (OR: 0.81; 95% CI: 0.67-0.99; p = 0.04) and ketoacidosis (OR: 0.73; 95% CI: 0.54-0.97; p = 0.03) were associated with a lower risk.
Conclusions: Acute confusional syndrome increases hospital mortality, especially in cases of septic shock and malignant tumors. This underscores the importance of timely diagnosis and treatment.


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