14th June 2021

A 62-year-old man is three days post-op on an orthopaedic ward

A 62-year-old man is three days post-op on an orthopaedic ward, having had a surgical fixation of an ankle fracture sustained in a fall. He becomes acutely confused during the night, asking where he is and pulling out his cannula before becoming agitated and trying to get out of bed. On assessment, he is slightly tachycardic at 110bpm, with the remainder of his vital signs being normal, there are no focal signs of infection, neurological examination is normal, and the only abnormality from blood tests is mild macrocytic anaemia and raised GGT level. On review of his notes, it has been documented that he usually drinks a bottle of whiskey a day.  

What is the most likely cause of this patient’s confusion?

Select the SINGLE most appropriate diagnosis from the list below. Select ONE option only.