When you hear the word “delir” or “delirium,” you usually automatically think of a clinical picture that you mistakenly assign to alcohol abuse. But delirium occurs in up to 50 percent of all hospitalized patients – and by no means only in alcoholics.
Definition: what is delirium?
Delirium is a clinical picture in which various other symptoms are present in addition to impaired consciousness and attention:
- First, perception is disturbed, often manifested by visual hallucinations. The best known of these are the proverbial white mice seen during delirium. Much more often, however, shadows or vermin scurrying through corners are seen. In addition, delusions, memory lapses and temporal disorientation are also possible.
- Furthermore, there are psychomotor disorders – often can be observed how the affected person nibbles at his bedspread, is very restless, does not want to stay in bed or talks much more or less than usual.
- The sleep-wake rhythm gets confused. A delirious person often can not sleep at night, his delirium symptoms worsen; during the day, however, the affected person is very sleepy and seems dazed.
- Affect is impaired: Anxiety, tearfulness, but also euphoria and aggressiveness occur.
Delirium often develops within hours: First, the affected person seems a bit confused, after a short time several of the above symptoms appear.
Overall, delirium occurs in 30 to 80 percent of all intensive care patients. In surgical patients, it is around 50 percent, depending on the procedure, and among hospital patients over 65 years of age, about half also develop a delirious state.
Causes of delirium
There are patients who are much more prone to a delirious state than others. Among these, both advanced age and very young age are risk factors for delirium development. In addition, the following factors also increase the risk:
- A preexisting brain injury
- An alcohol dependence
- A metabolic disease such as diabetes
- Fever
- A serious physical illness such as cancer
- Taking several different medications
If one of the risk factors is present and the person then also develops a disease of the brain, another serious illness such as an infection, a cardiac arrhythmia or a serious organ disease such as increasing kidney or liver failure, a delirious state can develop very quickly.
Many elderly people affected
Looking closely at both the risk factors and causes of delirium, it is not surprising that many people develop delirium in the hospital after the age of 65 – after all, a great many elderly people meet the requirements: Age, cardiovascular disease, metabolic problems, and multiple medications.
Certain diseases as risk factors
Delirium is particularly common with certain medical conditions: This is true for unplanned hip replacement surgery after a broken leg, burns, and open heart surgery.
Similarly, delirium often develops because of intoxication or withdrawal from substances that affect the brain. Such substances, in addition to alcohol, are primarily amphetamines, but also medications such as antidepressants or Parkinson’s drugs.
