Risk of Alcohol Withdrawal Syndrome in Hospitalized Trauma Patients: A National Data Analysis

Published on Aug 18, 2021in Injury-international Journal of The Care of The Injured2.106
· DOI :10.1016/J.INJURY.2021.08.017
Nasim Ahmed8
Estimated H-index: 8
Yen-Hong Kuo6
Estimated H-index: 6
BACKGROUND Alcohol withdrawal syndrome (AWS) is an uncommon occurrence in trauma victims. However, the syndrome can cause a prolonged hospital stay. Therefore, the purpose of this study is to develop and validate the risk factors of AWS so that interventions can be applied to high-risk patients. METHODS All adult trauma patients with an injury severity score of ≥1 and greater than one hospital day were included in the study. The Trauma Quality Improvement Program (TQIP) database from 2013-2016 was accessed for the study. Patient demography, injury and comorbidities were compared between the patients who developed AWS and who did not develop AWS. The data were split into 2 datasets: training and testing. Eighty percent (80%) of the data was randomly selected for the training dataset to develop the risk factors. The remaining 20% of the data were used for validation of the risk factors using multivariable analysis. The receiving operating characteristics (ROC) curve and area under the curve (AUC) were generated for model fitness. All P values <0.01 were considered statistically significant. RESULTS A total of 497,819 patients qualified for the study. Only 6,894 (1.38%) patients developed AWS during their hospitalization. The median age of the patients, who developed AWS, was 54 years. The patients were predominantly male (84% vs. 63.1%) and Caucasian (80.3% vs. 76.1%). The multivariable analysis showed an age range of 45 years to 74 years old, male gender, Caucasian race, a history of chronic alcoholic abuse, hypertension and cirrhosis increased the risk of AWS. The AUC of the model of 0.910, 95% CI; [0.901, 0.918] showed an excellent model for predicting the risk of the development of AWS. CONCLUSION Approximately 1.4% of the trauma victims developed AWS. Certain patient demographic and comorbidity characteristics, and head injury have a higher risk of developing of AWS.
📖 Papers frequently viewed together
#1Sushma Yerram (MU: University of Missouri)H-Index: 2
#2Nakul Katyal (MU: University of Missouri)H-Index: 6
Last. Christopher R. Newey (MU: University of Missouri)H-Index: 13
view all 5 authors...
Background Seizures are a considerable complication in critically ill patients. Their incidence is significantly high in neurosciences intensive care unit patients. Seizure prophylaxis with anti-epileptic drugs is a common practice in neurosciences intensive care unit. However, its utility in patients without clinical seizure, with an underlying neurological injury, is somewhat controversial.
#1Kristin Salottolo (Rocky Vista University College of Osteopathic Medicine)H-Index: 1
#2Emmett McGuireH-Index: 1
Last. David Bar-OrH-Index: 31
view all 5 authors...
Objectives:We sought to determine occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens in patients with traumatic injury.Design:Retrospective multicenter cohort study.Setting:Three U.S. trauma centers.Patients:Twenty-eight thousand one hundred one trauma patients
#1Steven Scaglione (UM: University of Michigan)H-Index: 7
Last. Michael L. VolkH-Index: 32
view all 7 authors...
Background and Aims:Liver cirrhosis is an important public health concern in the United States and a significant source of morbidity and mortality. However, the epidemiology of cirrhosis is incompletely understood. The aims of this study were to estimate the prevalence of cirrhosis in the general US
#1Randeep S. Jawa (SBU: Stony Brook University)H-Index: 17
#2Joseph C. StothertH-Index: 20
Last. David H. YoungH-Index: 5
view all 9 authors...
Abstract Background As alcohol use is highly prevalent in trauma patients, we hypothesized that a significant proportion of hospitalized trauma patients would demonstrate alcohol withdrawal (AW). Methods The trauma registries at a joint trauma center system from 1999 to 2008 were evaluated for patients aged at least 16 years. Results Of 19,369 trauma admissions, 159 patients had AW. Blood alcohol concentration (BAC) testing was performed in 31.5% of the patients. BAC was significantly higher in ...
#1José R. Maldonado (Stanford University)H-Index: 19
#2Yelizaveta Sher (Stanford University)H-Index: 13
Last. Anne Catherine Miller (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 2
view all 7 authors...
Background: To date, no screening tools for alcohol withdrawal syndromes (AWS) have been validated in the medically ill. Although several tools quantify the severity of AWS (e.g., Clinical Institute Withdrawal Assessment for Alcohol [CIWA]), none identify subjects at risk of AWS, thus missing the opportunity for timely prophylaxis. Moreover, there are no validated tools for the prediction of complicated (i.e., moderate to severe) AWS in the medically ill. Objectives: Our goals were (1) to conduc...
#1Herbert L. Muncie (LSU: Louisiana State University)H-Index: 5
#2Yasmin YasinianH-Index: 1
Last. Linda K Oge (LSU: Louisiana State University)H-Index: 3
view all 3 authors...
Approximately 2% to 9% of patients seen in a family physician's office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome if they abruptly abstain from alcohol use. Alcohol withdrawal syn- drome begins six to 24 hours after the last intake of alcohol, and the signs and symptoms include tremors, agitation, nausea, sweating, vomiting, hallucinations, insomnia, tachycardia, hypertension, delirium, and seizures. Treatment aims to minimize symptoms, prevent ...
#1Richard W. CarlsonH-Index: 14
#2Nivedita N. KumarH-Index: 1
Last. Shivaramaiah Shashikumar (SLU: Saint Louis University)H-Index: 1
view all 7 authors...
: In susceptible patients, alcohol withdrawal syndrome (AWS) is often precipitated by other medical or surgical disorders, and AWS can adversely affect the course of these underlying conditions. Although the mortality rate of AWS has decreased over the past few decades, significant risk for morbidity and death remain if management is complicated by a variety of conditions. This review of AWS focuses on the scope of the clinical problem, historical features, pathophysiology, clinical presentation...
#1Richard W. Wilsnack (UND: University of North Dakota)H-Index: 30
#2Sharon C. Wilsnack (UND: University of North Dakota)H-Index: 49
Last. Gerhard GmelH-Index: 74
view all 5 authors...
AIMS: To evaluate multinational patterns of gender- and age-specific alcohol consumption. DESIGN AND PARTICIPANTS: Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997-2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire. MEASUREMENTS: Data from men and women in three age groups (18-34, 35-49, 50-65) showed the prevalence of drinkers, former drinkers, and lifetime abstainers;...
Cited By0
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.