Delirium after surgery
Delirium is a sudden change in mental status, or sudden confusion, which develops over hours to days. Delirium makes paying attention or focusing difficult and sometimes affects the ability to maintain awareness of one's surroundings. Some people hallucinate or become paranoid because it becomes difficult to interpret their environment. Other symptoms may include rambling speech and jumbled thoughts. These symptoms tend to come and go during the course of the day. Confusion regarding day-to-day events, daily routines, and the roles of familiar people is common. Changes in personality can occur. Some persons become quiet and withdrawn (hypoactive) while others become agitated or hyperactive. Normal patterns of sleeping and eating are often disrupted.
In patients over 65 years of age, delirium can occur in up to 30 % after surgery and during hospitalisation. Delirium can be accompanied by life-threatening conditions and has a mortality rate in hospitalised patients that is similar to that of acute myocardial infarction or sepsis. In addition, delirium is often followed by a cascade of events that result in loss of independence, increased morbidity and increased healthcare costs. Delirium is common, but is still undetected in up to two-thirds of cases.
Delirium is a serious problem in hospitalized older patients and requires immediate treatment. Delirium can slow the healing or recovery process, leading to more time spent in the hospital or even worse in the intensive care unit.
There are some common causes of delirium that have been identified, such as infections, dehydration, side effects of certain medications, or the effect of drugs in the body along with other medical conditions. It is important to report a suspected delirious episode so that a medical professional, a nurse or relatives can help immediately. The sooner delirium is identified, the faster it can be treated.
How is the diagnosis made?
The diagnosis of a delirium is primarily based on the symptoms and the course of the disease. Information from relatives and caregivers is particularly important. Scales such as the CAM (confusion assessment method) are used to support the diagnosis. To find out the cause of the delirium, broad physical examinations such as laboratory values, imaging (CT or MRI), ECG (in individual cases EEG) and cerebrospinal fluid tests are necessary.
In patients over 65 years of age, delirium can occur in up to 30 % after surgery and during hospitalisation. Delirium can be accompanied by life-threatening conditions and has a mortality rate in hospitalised patients that is similar to that of acute myocardial infarction or sepsis. In addition, delirium is often followed by a cascade of events that result in loss of independence, increased morbidity and increased healthcare costs. Delirium is common, but is still undetected in up to two-thirds of cases.
Delirium is a serious problem in hospitalized older patients and requires immediate treatment. Delirium can slow the healing or recovery process, leading to more time spent in the hospital or even worse in the intensive care unit.
There are some common causes of delirium that have been identified, such as infections, dehydration, side effects of certain medications, or the effect of drugs in the body along with other medical conditions. It is important to report a suspected delirious episode so that a medical professional, a nurse or relatives can help immediately. The sooner delirium is identified, the faster it can be treated.
How is the diagnosis made?
The diagnosis of a delirium is primarily based on the symptoms and the course of the disease. Information from relatives and caregivers is particularly important. Scales such as the CAM (confusion assessment method) are used to support the diagnosis. To find out the cause of the delirium, broad physical examinations such as laboratory values, imaging (CT or MRI), ECG (in individual cases EEG) and cerebrospinal fluid tests are necessary.