What are the potential complications of untreated delirium tremens that I should be aware of in my practice?

Potential complications of untreated delirium tremens (DTs) include severe autonomic instability, seizures, dehydration, electrolyte imbalances, aspiration pneumonia, and death. Delirium tremens is a severe form of alcohol withdrawal that can rapidly progress to life-threatening complications if not promptly treated. The autonomic hyperactivity seen in DTs can cause tachycardia, hypertension, and hyperthermia, which may lead to cardiovascular collapse. Seizures are a common complication and can further worsen the clinical picture. Additionally, patients are at risk of dehydration and electrolyte disturbances due to vomiting, sweating, and reduced oral intake. Aspiration pneumonia may occur due to impaired consciousness and vomiting. Without appropriate medical intervention, these complications can culminate in death, highlighting the importance of early recognition and treatment in clinical practice ¹,².