[Severe course of delirium tremens. Results of treatment and late prognosis].
80 patients (P) (68 men and twelve women) with the diagnosis of delirium tremens were retrospectively analyzed and reexamined over a period of ten years (1974 to 1984). Included were only patients who--after failure of oral medication--required intravenous therapy with Chlomethiazol and thereby intensive care treatment. Mean age was 46.2 (26 to 75) years. During the observation period delirium tremens increased in frequency by 11% each year. Nine patients had two, six patients three and two patients four episodes of delirium tremens. In 86.7% delirium tremens occurred with fatty liver and alcoholic hepatitis, epileptic seizures, cirrhosis and hepatic coma, gastrointestinal hemorrhage and pancreatitis. Eight patients (10%) died in hospital at a mean age of 53.2 years. None of the deceased had less than three (on average four) complicating or associated diseases. These were mostly pneumonia, cirrhosis, hepatic coma, and gastrointestinal hemorrhage. The mean duration of intravenous Chlomethiazol therapy was 4.7 (0.25 to 20) days, the applied dose 26.2 (0.8 to 78.6) grams, there being no significant difference between survivors and non-survivors. Of the 72 survivors 62 were invited for follow-up examination after an average of five years. During this period another twelve patients (15%) died of pneumonia, gastrointestinal bleeding, cardiocirculatory failure and accidents. Life expectancy was only 9.3 years. Of 29 patients who came for follow-up, 55% showed clinical evidence of alcohol dependency, 65% had elevated gamma-glutamyl-transferase.(ABSTRACT TRUNCATED AT 250 WORDS)
Horstmann
E
E
Conrad
E
E
Daweke
H
H
D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy* / Q000401:mortality; D002719:Chlormethiazole / Q000008:administration & dosage*; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D005860:Germany, West; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011604:Psychoses, Alcoholic / Q000188:drug therapy*
D002719:Chlormethiazole
Das schwer verlaufende Delirium tremens. Behandlungsergebnisse und Spätprognose.