Confusion in the elderly: a differential diagnosis
A 94yo woman underwent surgical repair for bilateral femur fractures. Post-operatively the patient’s mentation fluctuated, she desaturated, and she had anisocoria. Given these acute changes the patient’s son agreed to intubation despite the patient’s DNR/DNI status. Medical workup including head CT revealed no etiology for her mentation changes. She was extubated the next day. Stroke, delirium, infection, dementia, and hypercapnia are some of the common etiologies of confusion in the elderly. This case explores the challenging workup of acute mentation changes in a post-operative geriatric patient in the setting of dementia, hearing loss, and anisocoria.
Khan H, Maheshwari N, Soto RG. Confusion in the elderly: a differential diagnosis. Abstract presented at: Anesthesiology 2019. American Society of Anesthesiology, Orlando, FL; 2019 October 19-23.