Trauma center admission risk conditions and the probability for developing alcohol withdrawal syndrome: A retrospective study

Marchand, Tiffany; Dunham, C. Michael; Chance, Elisha A.; Hileman, Barbara M

doi:10.1016/j.injury.2022.08.072

Cited by 1 publication

(5 citation statements)

References 46 publications

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“…Himmelstein’s study showed a significantly higher rate of AWS in men (264/281 patients, p < 0.05) ( 78 ). Marchand et al’s study ( 55 ) showed a non-significant trend for male sex as a risk factor for AWS [Relative risk (RR) = 2.2, 95% CI: 0.9–5.1, p = 0.06]. Steel et al’s study with inpatient veterans showed that male sex was associated with an increased probability of inpatient AWS ( p < 0.001) ( 74 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty of the studies (n = 65,087) separated the number of AWS patients by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. (55) showed a non-significant trend for male sex as a risk factor for AWS [Relative risk (RR) = 2.2, 95% CI: 0.9-5.1, p = 0.06]. Steel et al 's study with inpatient veterans showed that male sex was associated with an increased probability of inpatient AWS (p < 0.001) (74).…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, Wood et al ( 101 ) concluded in their review that having severe AWS was not more likely in men than in women [Likelihood ratio (LR) for men 1.3, 95% CI: 1.0–1.7]. Some studies report that male sex is a risk factor of developing severe AWS ( 40 , 55 ), while others do not ( 46 , 64 ).…”

Section: Discussionmentioning

confidence: 98%

“…In this review, not only were the studies heterogeneous based on geographical location, but also based on the treatment setting and populations. Studies focused on trauma patients ( 54 , 55 ), emergency room patients ( 25 , 37 ), inpatients who developed AWS ( 8 , 25 , 38 , 44 , 58 , 59 , 64 , 68 , 73–75 , 77 , 78 ), hospital patients presenting with AWS ( 39 , 43 , 45–47 , 63 , 67 , 70 , 71 , 74 ), research center patients ( 39 ), psychiatric hospital patients ( 41 ), and detoxification unit patients ( 77 ). All study populations were mostly adults, however, only one study ( 75 ) focused on AWS in adolescents, which led to different results, as discussed previously.…”

Section: Discussionmentioning

confidence: 99%

“…Among studies included, three studied used the Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar) (54)(55)(56) to measure the severity of AWS. Additionally, two studies used the Clinical Institute Withdrawal Assessment of Alcohol (CIWA-A) (57,58), and one used the Alcohol Withdrawal Scale (AWS) (59).…”

Section: Aws Severity Assessment Scalesmentioning

confidence: 99%

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Sex difference in alcohol withdrawal syndrome: a scoping review of clinical studies

Unlu,

Macaron,

Ayraler Taner

et al. 2023

Front. Psychiatry

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BackgroundWe conducted a review of all studies comparing clinical aspects of alcohol withdrawal syndrome (AWS) between men and women.MethodsFive databases (PubMed, Cochrane, EMBASE, Scopus and Clinical Trials) were searched for clinical studies using the keywords “alcohol withdrawal syndrome” or “delirium tremens” limited to “sex” or “gender” or “sex difference” or “gender difference.” The search was conducted on May 19, 2023. Two reviewers selected studies including both male and female patients with AWS, and they compared males and females in type of AWS symptoms, clinical course, complications, and treatment outcome.ResultsThirty-five observational studies were included with a total of 318,730 participants of which 75,346 had AWS. In twenty of the studies, the number of patients presenting with or developing AWS was separated by sex, resulting in a total of 8,159 (12.5%) female patients and a total of 56,928 (87.5%) male patients. Despite inconsistent results, males were more likely than females to develop complicated AWS [delirium tremens (DT) and AW seizures, collective DT in Males vs. females: 1,792 (85.4%) vs. 307 (14.6%), and collective seizures in males vs. females: 294 (78%) vs. 82 (22%)]. The rates of ICU admissions and hospital length of stay did not show sex differences. Although variable across studies, compared to females, males received benzodiazepine treatment at higher frequency and dose. One study reported that the time from first hospitalization for AWS to death was approximately 1.5 years shorter for males and males had higher mortality rate [19.5% (197/1,016)] compared to females [16% (26/163)].ConclusionDespite the significant heterogeneity of the studies selected and the lack of a focus on investigating potential sex differences, this review of clinical studies on AWS suggests that men and women exhibit different AWS manifestations. Large-scale studies focusing specifically on investigating sex difference in AWS are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%