The maximum alcohol withdrawal syndrome score associates with worse clinical outcomes - A retrospective cohort study
| Autor: | Alexandra Griessbach, Patrick E. Beeler, Edouard Battegay, Beatrice U. Mueller |
|---|---|
| Přispěvatelé: | University of Zurich, Beeler, Patrick E |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty 030508 substance abuse 610 Medicine & health UFSP13-4 Dynamics of Healthy Aging Logistic regression Toxicology Cohort Studies 03 medical and health sciences 2738 Psychiatry and Mental Health 0302 clinical medicine 11178 Center of Competence Multimorbidity Internal medicine medicine Humans 2736 Pharmacology (medical) Pharmacology (medical) 030212 general & internal medicine Hospital Mortality Retrospective Studies Pharmacology In hospital mortality business.industry 3005 Toxicology Retrospective cohort study Odds ratio Length of Stay Middle Aged medicine.disease Substance Withdrawal Syndrome Alcoholism Psychiatry and Mental health Treatment Outcome 3004 Pharmacology Alcohol withdrawal syndrome Female 10029 Clinic and Policlinic for Internal Medicine 0305 other medical science business |
| Popis: | Background The Wetterling alcohol withdrawal syndrome (AWS) scale determines withdrawal severity and guides treatment. We investigated associations between maximum AWS scores and clinical outcomes. Methods This retrospective cohort study considered AWS assessments measured from 8/2015-8/2017. We used multivariable linear and logistic regression to analyze associations between the maximum score and increased length of stay (LOS) and in-hospital mortality, respectively. Firstly, we investigated the maximum score of all AWS assessments any time during the stay, secondly, the maximum measured only within the first 3 days of withdrawal. Results A total of 2,464 hospital stays showed that, patients with “mild” ( 9) maximum scores had median LOS of 5.93, 9.35, 14.71 days, mortality was 1.7%, 4.8%, 8.0%, respectively. Regression showed that a higher maximum score was independently associated with increased LOS and mortality (both p Based on the maximum AWS score within the first 3 days, the median LOS was 6.18, 9.00, 12.89 days, mortality was 2.2%, 3.6%, 7.6%, respectively. A higher maximum score in the first 3 days was independently associated with increased LOS (p = 0.036) and mortality (p = 0.001). Severe maximum AWS scores within 3 days of withdrawal had an odds ratio of 2.53 (95% CI: 1.27, 4.82; p = 0.0060) for in-hospital death. Conclusions Maximum AWS scores associate independently with increased LOS and in-hospital mortality. This association is reproducible within the first 3 days of withdrawal. Development of such a 3-day tool could help clinicians assess the risk of worse clinical outcomes early on and adjust care accordingly. |
| Databáze: | OpenAIRE |
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