[Delirium: long-term sequelae and aftercare with special consideration to posttraumatic stress disorder].

Abstract

Delirium is a frequent syndrome among hospitalized patients, with a prevalence of 10-30% on general wards, up to 50% on palliative care units and 30-80% on intensive care units (ICU). Defined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) as an acute, reversible disturbance of attention, cognition and consciousness, delirium is associated with infections, surgery, trauma and other disease conditions. Risk factors include advanced age, pre-existing neurocognitive disorders and substance abuse. Delirium is associated with increased mortality, longer hospitalization and the occurrence of post-hospital discharge complications, including post-intensive care syndrome (PICS) and posttraumatic stress disorder (PTSD). A structured post-inpatient management is limited, highlighting the need for specialized aftercare clinics. On the ICU early detection through tools, such as confusion assessment method for the ICU (CAM-ICU) and preventive measures, including the ABCDEF bundle, are essential. Family involvement and patient education can mitigate long-term effects. A greater awareness of the impact of delirium and the long-term sequelae is crucial to improve patient recovery and to address both physical and psychological needs.