Prevalence And Correlates Of Delirium tremens In Alcohol Dependence Syndrome At Tertiary Hospital

Abstract

Introduction: The prevalence of Delirium tremens (DT) is around 5-12%. Very few studies have looked into the prevalence of DT in general population and has shown varying results. The study aims at finding the prevalence of delirium tremens among alcohol dependents (AD) and a comparison of profiles of alcohol withdrawal syndrome (AWS) with DT and AWS without DT.
 Material And Method: A case- control study was conducted in patients diagnosed as Alcohol dependent syndrome and admitted in Psychiatry in-patient ward for detoxification. Socio demographic and clinical variables were assessed and compared between alcohol dependents who developed DT and who did not developed DT.
 Results: 24% of the patients with AD had/developed delirium tremens. The multivariate regression analysis model shows variables like Age>50years (AOR= 75.7,95% C.I=7.8-730), Caste(Janjati: AOR=4.2, 95% C.I=1.329-13.23,) and unemployment(AOR=54.2, 95%C.I=3.8-765.254),longer length(years) of alcohol consumption >20 years(AOR= 305,95%CI=3.4-2711),presentation within 48-72 hrs since the last intake of alcohol (AOR=923,95%CI=38-22333),absence of nicotine consumption(AOR=40,95%C.I.=1.66-967) were significantly associated with development of delirium tremens. Similarly, those with educational status of higher secondary and above (AOR=0.7, 95% C.I =0.73-1.43), past history of absence of DT (AOR=0.013, 95% C.I=0.0002-0.77), less frequent intake of alcohol <3 times/week (AOR=0.001,95%C.I=0.001-0.07) had less likely developed DT. These significant variables were further assessed for their ability to predict the occurrence of delirium tremens in ROC and area under the curve for age, duration since last alcohol intake and years of intake of alcohol were respectively = 0.799, 0.843 and 0.765.
 Conclusion: Three features findings (older Age, more years of intake of alcohol, more hrs since last intake of alcohol) were more likely seen in delirium tremens patients.

Prevalence and Characteristics of Patients With Delirium Tremens: A Cross Sectional Study

“…The higher number of abs nent a empts could be because of the need for treatment the physical condi ons then as many had medical comorbidi es. Studies revealed that the average dura on of alcohol use was 20 and 24.8 years which is similar to ours with a median 14,16 dura on of 22 years. A longer dura on of alcohol intake 29 causes hyper excitability in the brain resul ng in DT.…”

“…In the study by Sarkar et al, Indian-made foreign liquor was most commonly 25 consumed. In studies from Nepal and our pa ents 14,16 consumed homemade (89.04%) alcohol.…”

“…Delirium tremens (DT) is a severe form of alcohol withdrawal syndrome (AWS) occurring usually a er 72 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) hours of the last alcohol drink. It comprises the symptoms of both delirium 1,4 and alcohol withdrawal.…”

Delirium Tremens: A Review of Clinical Studies

“…These studies helped identify high-risk patients who developed DT. The demographic profile of these populations typically consisted of middle-aged males with comorbidities and a history of long-term alcohol abuse [40][41][42][43][44][45][46]. Efforts should be directed toward prevention, early intervention, and long-term treatment of alcohol dependence to reduce the burden of DT and associated complications.…”