An Observational Study of Electrolytes and Other Metabolic Parameters in Patients with Delirium in Hospital Settings

Background: Despite extensive research, pathophysiology of delirium remains inadequately understood, with studies suggesting a role for inflammatory mediators, cholinergic deficiency, and metabolic disturbances. Aim: This study aims to explore the association of electrolytes and other metabolic parameters in hospitalized delirium patients as compared to age- and gender-matched nondelirious controls. Materials and Methods: The observational case–control study was conducted at a multispecialty hospital in eastern India where 100 inpatients diagnosed with delirium (cases) and an equal number of age- and gender-matched nondelirious inpatients (controls) were administered a semi-structured pro forma for sociodemographic variables and assessed for electrolytes and other metabolic parameters. Statistical analysis employed Pearson’s Chi-square test to assess the significance of differences between the two groups. Results: The study revealed statistically significant differences in metabolic disturbances in delirium cases as compared to controls with a greater association of hyperglycemia ( P = 0.009), hyponatremia ( P = 0.002), hypercalcemia ( P = 0.001), hyperkalemia ( P = 0.030), and hypokalemia ( P = 0.005) among delirium patients. Hypoalbuminemia ( P = 0.002) and elevated bilirubin levels ( P = 0.014) as well as uremia ( P < 0.001) and elevated creatinine levels ( P < 0.001) also had a greater association with delirium cases than controls. Sociodemographic analysis revealed a higher incidence of delirium in older adults and males. Conclusion: There was a significant association between delirium and various biochemical disturbances, highlighting the importance of thorough metabolic workup to identify and correct these disturbances which would potentially enhance delirium outcomes. There is a need for further studies to explore the causal pathways of these associations and the impact of targeted metabolic interventions on delirium outcomes.