Risk factors for delirium tremens in patients with alcohol withdrawal syndrome in a hospital setting

Monte, Rafael; Rey, Ramón Rabuñal; Casariego, Emilio; Bal, Mehmet Suat; Pértega, Sonia

doi:10.1016/j.ejim.2009.07.008

Cited by 49 publications

(45 citation statements)

References 24 publications

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“…There was significant variation among the studies with regard to the medical treatments administered for the treatment of alcohol withdrawal. While treatment was not standardized in a few studies (Ferguson et al, 1996;Wright et al, 2006), symptom-triggered benzodiazepines (Lee et al, 2005) or benzodiazepine-like clomethiazole (Eyer et al, 2011;Monte et al, 2009; Evaluated by 14 studies. 1 was a casecontrol study matched by age and gender (Brousse et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

“…1 was a casecontrol study matched by age and gender (Brousse et al, 2012). 6 reported data inadequately for aggregation (Ferguson et al, 1996;Fiellin et al, 2002;Lee et al, 2005;Mennecier et al, 2008;Shaw et al, 1998;Wetterling et al, 2001) MD not significant based on 5 studies (Eyer et al, 2011;Huang et al, 2011;Monte et al, 2009;Wetterling et al, 1994;Wright et al, 2006) with a total of 1,312 patients. 265 patients had DT.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Severe Alcohol Withdrawal Syndrome: A Systematic Review and Meta‐Analysis

Goodson

Clark

Douglas

2014

Alcoholism Clin & Exp Res

119

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Predictors of Severe Alcohol Withdrawal Syndrome: A Systematic Review and Meta‐Analysis

Goodson

Clark

Douglas

2014

Alcoholism Clin & Exp Res

119

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show abstract

“…It appears that the most robust predictor for an incident occurrence of DT or seizures is a history of a similar event 3, 10, 24, 25. Clinical findings such as elevated heart rate, systolic blood pressure, and temperature are all easily verifiable in the initial patient assessment, although their predictive value to identify patients with AWS who are more likely to develop DT is not high 3, 10, 26. In a patient with impaired consciousness, laboratory markers represent helpful tools to confirm the suspected clinical diagnosis of an AUD.…”

Section: Biomarkersmentioning

confidence: 99%

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

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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.

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“…Though the inherent risks of alcohol withdrawal are undisputed, a recently published study concluded that the mortality rate attributed to alcohol withdrawal syndrome has decreased since the beginning of the last century, especially in critical care units (20, 21). A number of factors have contributed to these improved survival rates, including improved management of delirium tremens, placement of patients in a carefully monitored ICU setting, and increased rates of timely endo tracheal intubation (21, 22).…”

Section: Discussionmentioning

confidence: 99%

Alcohol Withdrawal Prevention: A Randomized Evaluation of Lorazepam and Ethanol--A Pilot Study

Fullwood

Mostaghimi²,

Granger³

et al. 2013

American Journal of Critical Care

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Background Alcohol withdrawal syndrome, characterized by a hyperadrenergic state with confusion, agitation and hallucinations, has detrimental effects on patient safety in the context of acute myocardial infarction (MI). Unexpected hospitalization and sudden cessation of alcohol consumption may result in adverse outcomes including in-hospital complications, increased length of stay, and death. Strategies for safe and effective patient management have not been rigorously studied. Purpose We conducted a randomized evaluation of lorazepam and ethanol/lorazepam to evaluate the safety and efficacy of two strategies for the prevention of alcohol withdrawal syndrome in patients with acute coronary syndromes. Methods Patients (n=57) with myocardial infarction were screened for alcohol dependence using the CAGE questionnaire and randomized to lorazepam or to ethanol with lorazepam. Demographic group differences and complication rates were analyzed using chi square (categorical variables) and t-tests (continuous variables). Safety (composite complication rates) of the treatment strategy was evaluated using Fisher’s exact test. Length of stay was analyzed using Wilcoxon rank-sum test. Results Safety-associated complication rates (self-extubation, delirium tremens, re-infarction) were not different between groups (24% lorazepam vs. 18% ethanol; p=0.56). A trend toward fewer complications in the ethanol group was noted. In addition, no difference was detected between the treatment groups for days spent in the CCU (6.9% lorazepam vs. 2.4% ethanol; p = 0.32) or overall hospital stay (6.2% lorazepam vs. 6.4% ethanol; p = 0.72). Conclusions These findings suggest that a randomized evaluation of treatment strategies to prevent complications associated with alcohol withdrawal in acute MI is safe and feasible. A larger study may provide important evidence for improving clinical outcomes for patients experiencing alcohol withdrawal during acute myocardial infarction.

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Risk factors for delirium tremens in patients with alcohol withdrawal syndrome in a hospital setting

Cited by 49 publications

References 24 publications

Predictors of Severe Alcohol Withdrawal Syndrome: A Systematic Review and Meta‐Analysis

Predictors of Severe Alcohol Withdrawal Syndrome: A Systematic Review and Meta‐Analysis

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Alcohol Withdrawal Prevention: A Randomized Evaluation of Lorazepam and Ethanol--A Pilot Study

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