Delirium tremens natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

The symptoms of Delirium tremens usually start within 48 to 98 hours after the last drink in long term alcoholics. In some cases, it may occur up to 7 to 10 days after their last drink. Delirium tremens have a very high mortality rate if left untreated. Complications include, hypertension, hyperthermia, Heart attack, cardiac arrhythmia, stroke, seizure, respiratory failure, altered mental status, rhabdomyolysis and death. Prognosis largely depends upon early recognition and intervention. Mortality from Delirium tremens has been reduced from 35% to 5-15% due to early diagnosis and advanced ICU arrangements. Due to advanced treatment overall mortality is low, but it can vary in patient with other comorbidities including pulmonary insufficiencies, arrhythmia, pancreatitis, or if patient is older.

Natural History, Complications, and Prognosis

Natural History

The symptoms of Delirium tremens usually start within 48 to 98 hours after the last drink in long term alcoholics. In some cases, it may occur up to 7 to 10 days after their last drink. Delirium tremens have a very high mortality rate if left untreated.

Complications

Adrenergic storm can cause following complications:

• Hypertension
• Hyperthermia
• Heart attack
• Cardiac arrhythmia
• Stroke
• Seizure
• Respiratory failure
• Altered mental status
• Rhabdomyolysis

Prognosis

Prognosis largely depends upon early recognition and intervention. Mortality from Delirium tremens has been reduced from 35% to 5-15% due to early diagnosis and advanced ICU arrangements. Due to advanced treatment overall mortality is low, but it can vary in patient with other comorbidities including pulmonary insufficiencies, arrhythmia, pancreatitis, or if patient is older. Some Delirium tremens symptoms may last for a year or more, including, emotional mood swings, fatigue, and/or sleeplessness.