Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures

Kim, Dong Wook; Kim, Hyun Kyung; Bae, Eun‐Ah; Park, Sohee; Kim, Kwang Ki

doi:10.1016/j.ajem.2015.02.030

Cited by 36 publications

(29 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 6 7 ] Previous studies have also found other predictors of AWD, i.e., thrombocytopenia,[ 10 19 20 ] hypertension,[ 15 16 ] medical comorbidity,[ 9 16 17 ] hypokalemia,[ 20 21 ] tachycardia,[ 7 17 ] hyperthermia,[ 15 ] and hypertension[ 15 16 22 ] and also association of DT with high blood homocysteine level and low blood level of pyridoxine in a recent study by Kim et al . [ 19 ] In most of the earlier studies, the risk factors were more laboratory based[ 6 9 19 ] which might not be useful where such facilities are not available like in a primary health-care system. Our study focused on the importance of a relevant clinical history in predicting delirium, and thus early screening of patients with SAWS may help to prevent them from developing subsequent withdrawal delirium.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for the development of delirium in alcohol dependence syndrome: Clinical and neurobiological implications

Sarkar

Choudhury

Ezhumalai

et al. 2017

Indian J Psychiatry

View full text Add to dashboard Cite

Introduction:Alcohol withdrawal delirium (AWD) or delirium tremens (DT) is associated with severe complications and high mortality. Prospectively identifying patients with increased risk of developing DT would have important preventive and therapeutic implications. Thus, the present study aimed to identify clinical risk factors predicting the development of DT.Materials and Methods:The study was a cross-sectional quasi-experimental one with equivalent control group, conducted at a tertiary hospital from August 2014 to May 2015. Forty adult male inpatients, diagnosed with DT, were compared with forty age- and sex-matched inpatients in alcohol withdrawal state without delirium. Assessments were done using confusion assessment method, Clinical Institute Withdrawal Assessment of Alcohol Scale, and Mini–Mental Status Examination. For group comparisons, Pearson's Chi-square test and independent sample t-test were used; logistic regression was applied to identify predictors followed by receiver operating characteristic curve analysis.Results:Heavy drinking (P = 0.005; odds ratio [OR]: 1.17, confidence interval [CI]: 1.05–1.31), continuous pattern of drinking (P = 0.027; OR: 4.67, CI: 1.19–18.33), past history of delirium (P = 0.009; OR: 552.8, CI: 4.88–625.7), alcohol-induced psychosis (P = 0.002; OR: 74.6, CI: 4.68–1190), and presence of cognitive deficits (P = 0.044; OR: 12.5, CI: 1.07–147.3) emerged as strong predictors of AWD.Conclusion:The risk factors found can be easily evaluated in a clinical setting for physicians to readily identify patients at risk for developing DT and plan intensive therapies for them. At a neurobiological level, patients with preexisting brain neurotransmitter disturbances are at greater risk for developing DT.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for the development of delirium in alcohol dependence syndrome: Clinical and neurobiological implications

Sarkar

Choudhury

Ezhumalai

et al. 2017

Indian J Psychiatry

View full text Add to dashboard Cite

show abstract

“…Severe AWS involves changes in electrolytes, especially potassium that is due to increased catecholamine activity with activation of the sodium–potassium ATPase pump and elevated vasopressin 25. Hypokalemia is not specific for alcohol consumption but is frequently reported to be associated with DT or seizures 10, 25, 28, 29. The same applies to thrombocytopenia (with high negative predictive value)10, 24, 25, 29, 30 that additionally is predictive of an incident occurrence of DT and seizures 25.…”

Section: Biomarkersmentioning

confidence: 99%

“…Hypokalemia is not specific for alcohol consumption but is frequently reported to be associated with DT or seizures 10, 25, 28, 29. The same applies to thrombocytopenia (with high negative predictive value)10, 24, 25, 29, 30 that additionally is predictive of an incident occurrence of DT and seizures 25. More indirect markers, such as AST, ALT, γGT, and MCV, are widely available and relatively inexpensive, but their predictive value is restricted because of low specificity.…”

Section: Biomarkersmentioning

confidence: 99%

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

View full text Add to dashboard Cite

The alcohol withdrawal syndrome is a well‐known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. Nonetheless, diagnosis and treatment are often delayed until dramatic symptoms occur. The purpose of this review is to increase the awareness of the early clinical manifestations of AWS and the appropriate identification and management of this important condition in a neurological setting.

show abstract

“…ст. та гіпетермія більше 38 ℃ [5], тахікардія більше 100 уд./хв [6], супутня медична патологія [7], одночасне вживання інших психотропних препаратів [8]. В одному з найбільш нових опублікованих досліджень, факторами ризику важкого стану відміни з потребою у госпіталізації у ВІТ, були біла раса пацієнта [9], молодий вік та відсутність працевлаштування [10].…”

Section: обговорення результатівunclassified

Predictors of severe alcohol withdrawal state in hospitalised patients

Бєлка¹

2015

ScienceRise

View full text Add to dashboard Cite

Проспективне обсерваційне дослідження предикторів важкого стану відміни алкоголю (СВА) включило 336 госпіталізованих пацієнтів. Достовірними предикторами розвитку важкого стану відміни алкоголю були попередні СВА в анамнезі або судоми пов'язані зі СВА, вживання інших психоактивних речовин, тахікардія більше 110 уд./хв., тромбоцитопенія менше 100*103 mk/L, цироз печінки кл. В та С за Чайлд-Пью Ключові слова: стан відміни алкоголю, фактори ризику, предиктори, інтенсивна терапія, зловживання алкоголем The objective of this study was to develop a prediction model for severe alcohol withdrawal syndrome (AWS) in hospitalized AWS patients. Медичні науки Scientific Journal «ScienceRise» №10/3(15)2015 128 Methods: 336 patients were admitted to this observational prospective study. Multivariable binary regression models with stepwise selection procedures were conducted providing odds ratio (OR) estimates.

show abstract

Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures

Cited by 36 publications

References 18 publications

Risk factors for the development of delirium in alcohol dependence syndrome: Clinical and neurobiological implications

Risk factors for the development of delirium in alcohol dependence syndrome: Clinical and neurobiological implications

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Predictors of severe alcohol withdrawal state in hospitalised patients

Contact Info

Product

Resources

About