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Journal article
Predictors of Escalation to Intensive Care Unit Level of Care Among Admissions for Alcohol Withdrawal
Journal of community hospital internal medicine perspectives, v 13(5), pp 8-14
02 Sep 2023
PMID: 37868680
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
According to the 2019 National Survey on Drug Use and Health, 14.5 million people ages 12 and older had alcohol abuse disorder. Alcohol withdrawal syndrome (AWS) can be defined as a collection of physical symptoms experienced due to abrupt cessation of alcohol after long-term dependence. In instances where regular inpatient management fails to control AWS symptoms, patients are shifted to intensive care units (ICUs) for closer monitoring and prevention of life-threatening complications like withdrawal seizures and delirium tremens (DTs), labeled as severe alcohol withdrawal syndrome (SAWS). Although this represents a significant healthcare burden, minimal studies have been conducted to determine objective predictors. In this study, we aim to determine the effect of patient demographics, socio-economic status, biochemical parameters, and clinical factors on the need for escalation to ICU level of care among admissions for AWS. Our study showed that factors such as a history of DTs or alcohol-related seizures, the initial protocol of man-agement, degree of reported alcohol usage, activation of rapid response teams, mean corpuscular value, alcohol level on admission, highest Clinical Institute Withdrawal Assessment Alcohol Revised (CIWA-Ar) scored during the hospital stay, and the total amount of sedatives used were significantly associated with escalation to ICU level of care. Clinicians must use these objective parameters to identify high-risk patients and intervene early. We encourage further studies to establish a scoring algorithm incorporating biochemical parameters to tailor management algorithms that might better suit high-risk patients.
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Details
- Title
- Predictors of Escalation to Intensive Care Unit Level of Care Among Admissions for Alcohol Withdrawal
- Creators
- Gaurav Mohan - King Hussein Cancer CenterPoorva Bhide - Monmouth Medical CenterAmer Abu-Shanab - King Hussein Cancer CenterMedha Ghose - Monmouth Medical CenterAdhithya Rajamohan - Monmouth Medical CenterTayyeb Muhammad - Rutgers Monmouth Med Ctr, Dept Internal Med, Long Branch, NJ USAAnosh A. Khan - Monmouth Medical CenterMahrukh Khan - Monmouth Medical CenterFarhan Khalid - Monmouth Medical CenterRana P. Padappayil - Monmouth Medical CenterDoantrang Du - Monmouth Medical Center
- Publication Details
- Journal of community hospital internal medicine perspectives, v 13(5), pp 8-14
- Publisher
- DIGITAL COMMONS BEPRESS
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychiatry; Pediatrics
- Web of Science ID
- WOS:001104683300017
- Other Identifier
- 991021930913504721
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- Collaboration types
- International collaboration
- Web of Science research areas
- Substance Abuse