Introduction
A continuity syndrome is the occurrence of various and unspecifically triggered mental disorders. The syndrome occurs particularly frequently after larger and longer surgical operations.
Frequency
Temporary states of confusion are quite common in hospitalized or postoperative patients. However, due to the wide range of symptoms, it is difficult to provide precise information, and literature references vary widely. There seems to be a correlation with the severity of the disease or surgical intervention, as well as with the personality and age of the patients, social environment and the extent of preoperative education.
Cause
The triggers of a continuity syndrome are unspecific and ultimately not clarified. It is suspected that there is an interplay between particular stress associated with severe physical illness or surgical procedures and existing fears of the patient. Since acute states of confusion can generally have a variety of causes, extensive differential diagnostics may be necessary to exclude underlying threatening health disorders.
Passage syndrome after surgery
Transitional syndrome occurs between 15 and 50 percent in patients after major surgery. Postoperatively, acute disturbances in thinking, feeling and psychomotor functions occur in the patient. Patients are confused about time and place and at the same time hyperactive, so they often pull on catheters or tubes.
Changes in consciousness such as delirium can also occur. Symptoms such as confusion, visual hallucinations, anxiety and fear can occur. The patients are disoriented and especially suffer from physical restlessness.
Often, good monitoring is required to prevent those affected from injuring themselves or pulling important access points. Their performance is extremely limited. People over the age of 60 are often affected by a passage syndrome.
When the syndrome occurs can also be very different. Some patients wake up in the recovery room after the operation and are immediately conspicuous. In other patients, the symptoms mentioned can also develop within the first hours or even after days.
In addition, the symptoms can be of varying severity. It is not yet known exactly why the Durchgangssyndrom occurs. Among the causes are several factors that interact to promote the development of delirium.
Older patients develop the syndrome more frequently than younger ones. More male patients are affected. In addition, pre-existing conditions such as diabetes mellitus, high blood pressure (hypertension) and also overweight (obesity) play just as important a role as the type and duration of the operation.
Thus, after passage syndrome, it is more likely to occur during heart surgery or in the treatment of fractures of the neck of the femur. The causes are still being researched. It is suspected that inflammatory processes in the brain occur during the operation as part of various underlying diseases.
Due to this irritation, the immune system is permanently activated and overloaded. A surgical intervention, moreover, leads to a complete overstraining of the immune system. This results in very strong defensive reactions, which additionally damage the brain, especially in the first hours after the operation.
In most cases, the transit syndrome is a temporary condition. The symptoms regress and the patient completely clears up again. Only in the rarest cases does the adeptness and disorientation remain permanently, so that the patient becomes a permanent case of nursing care.
All articles in this series:
