دورية أكاديمية
A Simplified Protocol for the Treatment of Alcohol Withdrawal.
| العنوان: | A Simplified Protocol for the Treatment of Alcohol Withdrawal. |
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| المؤلفون: | Feeney C; Department of Medicine (C.F., E.J., I.S.); Department of Emergency Medicine (H.J.A., R.C.C.); Highland Hospital-Alameda Health System and the Department of Emergency Medicine Kaiser East Bay (M.R.), Oakland, CA; SUNY Downstate College of Medicine (S.S.), Brooklyn, NY; and Department of Medicine, University of California (C.F., H.J.A., I.S.), San Francisco, CA., Alter HJ, Jacobsen E, Rehrer M, Shao S, Subramanian I, Clements RC |
| المصدر: | Journal of addiction medicine [J Addict Med] 2015 Nov-Dec; Vol. 9 (6), pp. 485-90. |
| نوع المنشور: | Evaluation Study; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: Netherlands NLM ID: 101306759 Publication Model: Print Cited Medium: Internet ISSN: 1935-3227 (Electronic) Linking ISSN: 19320620 NLM ISO Abbreviation: J Addict Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: [Alphen aan den Rijn, the Netherlands] : Wolters Kluwer Health, Inc. Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Clinical Protocols*, Hypnotics and Sedatives/*administration & dosage , Lorazepam/*administration & dosage , Psychoses, Alcoholic/*complications , Substance Withdrawal Syndrome/*drug therapy, Adult ; California ; Female ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Psychoses, Alcoholic/drug therapy ; Retrospective Studies ; Severity of Illness Index ; Substance Withdrawal Syndrome/diagnosis |
| مستخلص: | Objectives: The aim of the study was to evaluate a novel simplified tool for symptom-triggered treatment of alcohol withdrawal. Methods: This retrospective cohort study involved inpatients in a county hospital with an International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis of alcohol withdrawal syndrome (AWS) or delirium tremens between January 1, 2007 and December 31, 2008. The study used the Highland Alcohol Withdrawal Protocol (HAWP)-a simplified derivative of the Revised Clinical Institute Withdrawal Assessment for Alcohol. Multivariable regression analysis was performed to compare severity of withdrawal to hospital length of stay, total dose of sedative given, and risk of complications. Results: The study identified 442 patients with a primary diagnosis of AWS or delirium tremens, and those with another primary medical diagnosis complicated by alcohol withdrawal. After adjusting for demographic variables, each one-point increase in the initial and maximum HAWP scores correlated with an increase in the hospital length of stay of 0.3 days [95% confidence interval (95% CI), 0.17 to 0.43 days] and 0.45 days (95% CI, 0.32-0.57 days), and a 15.8 mg (95% CI, 6.6-25.1 mg) and 19.8 mg (95% CI, 11.1-28.5 mg) increase in the total dose of lorazepam given, respectively. The complication rate of seizures, intubations, pneumonia, and death was 13.1%, 12.9%, 6.1% and 0.9%, respectively; a composite endpoint of these outcomes also correlated with initial and maximum HAWP scores (odds ratio 1.09, 95% CI, 1.03%-1.14%). Conclusions: The HAWP correlates with medication received and complications, and as such appears to give an indication of AWS severity. It is feasible and shorter than prior scales, and merits further study to confirm its effectiveness as part of symptom-triggered protocols to manage alcohol withdrawal in the hospital. |
| المشرفين على المادة: | 0 (Hypnotics and Sedatives) O26FZP769L (Lorazepam) |
| تواريخ الأحداث: | Date Created: 20151027 Date Completed: 20160816 Latest Revision: 20191210 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1097/ADM.0000000000000167 |
| PMID: | 26501787 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1935-3227 |
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| DOI: | 10.1097/ADM.0000000000000167 |