Impact of Age on the Severity, Course, and Complications of Alcohol Withdrawal

Kraemer, Kevin L.; Mayo‐Smith, Michael F.; Calkins, David R.

doi:10.1001/archinte.1997.00440400084010

Cited by 40 publications

(9 citation statements)

References 47 publications

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“…The difference in terms of delirium presentation is statistically significant (P = 0.000*). Our study findings are in agreement with other studies (Kraemer et al and Wetterling et al) 17,18 that there is no relation between age and development of delirium in alcohol dependent individuals. We found that individuals with medical co-morbidity hypertension (42 of 104) and both hypertension & diabetes (12 of 31) have presented a greater number of delirium cases compared to diabetes alone (4 of 31), without any comorbidity (208 of 503), which was statistically significant (p =0.01*) (X 2 = 9.9).…”

Section: Discussionsupporting

confidence: 94%

Prevalence of alcohol dependence syndrome cases with and without delirium during the first phase of lockdown in Telangana

Rao¹,

Aditya²,

M³

2020

Telangana J Psychiatry

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Objectives: To determine the prevalence, association of socio-demographic factors, medical comorbidities with delirium in alcohol dependence syndrome individuals hospitalized during the lockdown period. Design: 667 alcohol-dependent patients attending the institute of mental health, Hyderabad during the 1st phase of lockdown were studied retrospectively with the help of hospital records. Results: Out of 667 samples 266 individuals presented with delirium. There is no significance of sociodemographic factors on delirium except sex. There is a positive correlation between severity of dependence (r=0.26, p=0.000), number of drinks (r=0.271, p=0.000) per day, duration of intake of substance (r=0.137, p=0.000) with delirium. Individuals with medical comorbidity hypertension, both hypertension and diabetes have presented a greater number of delirium cases. Conclusion: Current lockdown scenario is the first time we had faced. We found a greater prevalence of delirium in alcohol dependence cases which is a threat to the health care system. Hence further research in risk factors involving delirium presentation is needed. Stringent rules to control alcohol dependence to avoid a similar situation in the future and effective management of health care facilities are needed.

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Section: Discussionsupporting

confidence: 94%

Prevalence of alcohol dependence syndrome cases with and without delirium during the first phase of lockdown in Telangana

Rao¹,

Aditya²,

M³

2020

Telangana J Psychiatry

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“…The second highest recorded delirium rate among patients with delirium/encephalopathy was for alcohol intoxication/withdrawal delirium. Age is a potential predictor of alcohol withdrawal severity and complications; Kraemer et al 40 found that 14% of elderly patients admitted to an alcohol detoxification unit had delirium during alcohol withdrawal. Prior studies have found that elderly patients had significantly more alcohol withdrawal symptoms for a longer duration than did younger patients.…”

Section: Discussionmentioning

confidence: 99%

Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition

Kales

Kamholz

Visnic

et al. 2003

J Geriatr Psychiatry Neurol

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This retrospective study examined delirium and related confusional diagnoses recorded in patients older than age 60 discharged from Veterans Affairs (VA) acute inpatient units nationally in 1996 (n = 267,947). Only 4% of patients had delirium or related confusional diagnoses recorded. Patients with recorded delirium had significantly higher mortality than did those without recorded delirium or those with other confusional diagnoses ("organic psychoses"); the most common delirium types were dementia with delirium and alcohol intoxication/withdrawal delirium. Organic psychoses patients had the longest lengths of stay and significantly more admissions to nonmedical/surgical units and discharges to nursing homes; almost 20% were African American. The recorded rate of delirium in the VA health system likely underestimates true prevalence and possibly reflects nonrecognition of delirium in many older veterans. Certain motoric and etiologic types of delirium may be more commonly diagnosed and recorded. Future research should prospectively examine recognition of motoric and etiologic delirium subtypes and racial differences in delirium diagnoses.

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“…We recorded the occurrence of withdrawal complications including delirium, falls, dependency in activities of daily living, need for intravenous fluids, neuroleptic use, physical restraint use, and vital sign instability. Methods for ascertainment of these outcomes have been previously described (36). The diagnosis of delirium was based on DSM-TV criteria for delirium that had been operationalized and validated in the Confusion Assessment Method (CAM) (37).…”

Section: Data Collectionmentioning

confidence: 99%

Independent Clinical Correlates of Severe Alcohol Withdrawal

2003

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This retrospective cohort study sought to identify clinical variables that independently correlate with severe alcohol withdrawal and to quantify risk in a clinically useful manner. The records of 284 inpatients admitted to an acute detoxification unit at a Veterans Affairs teaching hospital were reviewed. Clinical data were recorded on standardized forms at the time of admission and abstracted by a physician reviewer. Alcohol withdrawal severity was prospectively measured with the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Seventy-one patients (25% of cohort) had severe withdrawal. We identified six independent correlates of severe withdrawal: use of a morning eye-opener (adjusted odds ratio [OR], 5.6; 95% confidence interval [CI], 1.2-25.9), an initial CIWA-Ar score > or =10 (OR, 5.1; 95% CI, 2.4-10.6), a serum aspartate aminotransferase > or =80 U/L (OR, 4.2; 95% CI, 2.0-8.8), past benzodiazepine use (OR, 3.6; 95% CI, 1.3-9.9), self-reported history of "delirium tremens" (OR, 2.9; 95% CI, 1.3-6.2), and prior participation in two or more alcohol treatment programs (OR, 2.6; 95% CI, 1.3-5.6). Significantly higher risk was observed in subjects with three or more independent correlates. In conclusion, several readily available clinical variables correlate with the occurrence of severe alcohol withdrawal. Ascertainment of these variables early in the course of alcohol withdrawal has the potential to improve triage and treatment decisions.

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Impact of Age on the Severity, Course, and Complications of Alcohol Withdrawal

Cited by 40 publications

References 47 publications

Prevalence of alcohol dependence syndrome cases with and without delirium during the first phase of lockdown in Telangana

Prevalence of alcohol dependence syndrome cases with and without delirium during the first phase of lockdown in Telangana

Recorded Delirium in a National Sample of Elderly Inpatients: Potential Implications for Recognition

Independent Clinical Correlates of Severe Alcohol Withdrawal

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