Síndrome de abstinencia alcohólica en pacientes hospitalizados

Monte-Secades, Rafael; Rey, Ramón Rabuñal; Guerrero-Sande, Héctor

doi:10.1016/j.rce.2014.11.013

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…In delirium, there is a disruption in gamma-aminobutyric acid (GABA), glutamate, and dopaminergic systems, which is also the case in psychosis as well as in patients having cognitive dysfunction. [ 1 23 24 ] Therefore, DT can be viewed as brain pathology occurring in a preexisting disturbance of brain neurotransmitter systems.…”

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

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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.

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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

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“…( 1,6,25,34) Delirium secundario a abstinencia alcohólica · Diazepam 10-20 mg por VO cada 6 horas durante 48 horas, con dosis adicionales de 10-20 mg cada 1-2 horas en función de los síntomas. Posteriormente descender un 25% de la dosis diariamente hasta la resolución completa.…”

Section: Adicionales Según Indicaciónunclassified

Delirium: an update for internists and psychiatrists

Torales

Barrios

Armoa

2017

Rev. virtual Soc. Parag. Med. Int

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RESUMENA lo largo del tiempo, al delirium se lo ha conocido por diversos nombres: falla cerebral aguda, síndrome cerebral orgánico agudo, síndrome confusional o psicosis postquirúrgica. No obstante, el término preferido en la actualidad es delirium (de latín delirare, que significa "arar fuera del surco"). El delirium, como síndrome, es un conjunto de signos y síntomas de inicio agudo caracterizado por deterioro cognitivo fluctuante, con enturbiamiento de la conciencia y capacidad disminuida de mantener y cambiar la atención de un punto a otro.Numerosos estudios han demostrado que los pacientes que desarrollan delirium tienen un riesgo aumentado de resultados adversos tanto durante la hospitalización como tras el alta. Este riesgo es independiente de cualquier comorbilidad existente, de la severidad de la enfermedad, la edad u otras variables asociadas. Asimismo, el delirium está asociado a un incremento en la mortalidad, aumento del tiempo de hospitalización y desarrollo de disfunciones cognitivas posteriores al alta.Este artículo de revisión presenta una actualización acerca de la fisiopatología del delirium, de las herramientas de reconocimiento del cuadro y de su tratamiento. Todas estas informaciones resultan útiles en el manejo diario de este tipo de pacientes, tanto por médicos internistas como por médicos psiquiatras. Palabras claves:ABSTRACT Over time, delirium has been known by several names: acute brain failure, acute organic brain syndrome, confusional syndrome, or post-surgical psychosis. However, the currently preferred term is delirium (from the Latin term delirare, which means "to go out of the furrow"). Delirium, as a syndrome, is a set of signs and symptoms of acute onset characterized by fluctuating cognitive impairment, clouding of consciousness and diminished ability to maintain and shift attention from one point to another. Numerous studies have shown that patients who develop delirium have an increased risk of adverse outcomes both during hospitalization and after discharge. This risk is independent of any existing comorbidity, severity of disease, age or other associated variables. Likewise, delirium is associated with an increase in mortality, delirio, trastornos neurocognitivos, síndrome confusional, delirio -fisiopatología, delirio -tratamiento farmacológico

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“…Puede dar lugar a crisis convulsivas (también llamadas rum fits) con lo que puede empeorar el daño neuronal ya existente. (33,34) El efecto del alcohol sobre el SNC es en ocasiones muy complejo y no queda claramente establecido si el daño se debe a las secuelas de un episodio de encefalopatía de Wernicke, al daño crónico que produce demencia alcohólica o a otras causas. En este contexto se ha acuñado el término ARBI (alcohol related brain injury) o ARCI (alcohol related cognitive impairment), concepto cuya definición e implicaciones todavía está en desarrollo.…”

Section: Cuestionarios De Valoración Del Consumo De Riesgounclassified

Polimorfismos genéticos del sistema dopaminérgico, GABA, BDNF Y NPY y su relación con la dependencia alcohólica

G¹,

Patricia²

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Síndrome de abstinencia alcohólica en pacientes hospitalizados

Cited by 7 publications

References 41 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

Delirium: an update for internists and psychiatrists

Polimorfismos genéticos del sistema dopaminérgico, GABA, BDNF Y NPY y su relación con la dependencia alcohólica

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