Clinical, laboratory, etiological profile and outcome of encephalopathy in elderly

Abstract Encephalopathy, a condition characterized by diffuse cerebral dysfunction, is prevalent among the elderly, with estimates ranging from 10% to 40%. This prospective observational study, conducted over 18 months at SKIMS Medical College and Hospital, Srinagar, aimed to evaluate the clinical, laboratory, and etiological profiles of encephalopathy in elderly patients (≥ 60 years) with a Glasgow Coma Scale (GCS) < 15. A total of 138 patients were included, with 63% aged 60–70 years and 55% being male. Hypertension (84.8%) and diabetes (26.8%) were the most common comorbidities. Altered sensorium (98.6%) was the predominant symptom. Metabolic encephalopathy (29.71%) was the most frequent type, followed by multifactorial (26.08%), septic (25.36%), and neurologic (16.66%) causes. Key findings included significant associations between septic and neurologic encephalopathy and mortality ( p < 0.001 and p = 0.045, respectively). Laboratory results revealed higher urea, creatinine, and lactate levels in expired patients ( p < 0.05). The mortality rate was 46.4%, with septic encephalopathy being a significant predictor of poor outcomes. This study highlights the need for early diagnosis and targeted management to improve survival and reduce long-term cognitive deficits in elderly encephalopathy patients. Further research is warranted to explore regional variations and optimize treatment strategies.