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Abstract
Objectives
The aim of this study was to analyze the clinical variables associated with the occurrence, duration, and severity of alcohol withdrawal delirium (AWD) in patients with alcohol dependence.
Methods
We conducted a retrospective case-control study in alcohol dependent inpatients admitted to the psychiatric department, between 2006 and 2012 (n=863). Multivariable logistic and linear regression models were used for analysis of risk factors associated with development of AWD and the duration of illness, respectively. And multivariable logistic regression models were applied for assessment of risk factors associated with seclusions or physical restraints, which reflect the severity of AWD.
Results
Significant predictors for the occurrence of AWD included higher body temperature, lower platelet count, lower serum potassium, higher drinking amount, history of AWD, and history of head trauma or structural brain lesion. Variables associated with prolongation of delirium included higher body temperature, higher drinking amount, and less use of benzodiazepine during the AWD episode. Significant predictors for severe AWD included higher systolic blood pressure, longer duration of harmful alcohol use, and higher drinking amount.
Conclusion
Easily determinable parameters, such as vital signs and past history related to drinking are significantly associated with not only development of AWD, but also its severity and duration. Therefore, when initially assessing alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent occurrence of risky withdrawal delirium and behavioral problems.
Figures and Tables
Table 2
Biochemical variables of alcohol dependence patients with and without AWD
*: p<0.05, **: p<0.01, ***: p<0.001, †: Systolic blood pressure in first 24 hours after admission, ‡: Highest axillary temperature in first 24 hours after admission. AWD : Alcohol withdrawal delirium, MCV : Mean corpuscular volume, AST : Aspartate aminotransferase, ALT : Alanine aminotransferase, GGTP : Gamma-glutamyl-transpeptidase, BUN : Blood urea nitrogen, SD : Standard deviation
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