Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File.

Autor:	Jones TJ; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Bhattacharya B; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Schuster KM; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Becher RD; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Kodadek LM; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Davis KA; Surgery, Yale School of Medicine, New Haven, Connecticut, USA., Maung AA; Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
Jazyk:	angličtina
Zdroj:	Trauma surgery & acute care open [Trauma Surg Acute Care Open] 2023 Mar 03; Vol. 8 (1), pp. e001047. Date of Electronic Publication: 2023 Mar 03 (Print Publication: 2023).
DOI:	10.1136/tsaco-2022-001047
Abstrakt:	Objective: To identify the rates and possible predictors of alcohol withdrawal syndrome (AWS) among adult trauma patients. Methods: This is a retrospective review of all adult patients (18 years or older) included in the 2017 and 2018 American College of Surgeons Trauma Quality Program Participant User File (PUF). The main outcomes were rates and predictors of AWS. Results: 1 677 351 adult patients were included in the analysis. AWS was reported in 11 056 (0.7%). The rate increased to 0.9% in patients admitted for more than 2 days and 1.1% in those admitted for more than 3 days. Patients with AWS were more likely to be male (82.7% vs. 60.7%, p<0.001), have a history of alcohol use disorder (AUD) (70.3% vs. 5.6%, p<0.001) and have a positive blood alcohol concentration (BAC) on admission (68.2% vs. 28.6%, p<0.001). In a multivariable logistic regression, history of AUD (OR 12.9, 95% CI 12.1 to 13.7), cirrhosis (OR 2.1, 95% CI 1.9 to 2.3), positive toxicology screen for barbiturates (OR 2.1, 95% CI 1.6 to 2.7), tricyclic antidepressants (OR 2.2, 95% CI 1.5 to 3.1) or alcohol (OR 2.5, 95% CI 2.4 to 2.7), and Abbreviated Injury Scale head score of ≥3 (OR 1.7, 95% CI 1.6 to 1.8) were the strongest predictors for AWS. Conversely, only 2.7% of patients with a positive BAC on admission, 7.6% with a history of AUD and 4.9% with cirrhosis developed AWS. Conclusion: AWS after trauma was an uncommon occurrence in the patients in the PUF, even in higher-risk patient populations. Level of Evidence: IV: retrospective study with more than one negative criterion. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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