JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Symptom-triggered therapy for alcohol withdrawal syndrome in medical inpatients.

OBJECTIVE: To assess the efficacy of symptom-triggered therapy vs usual care for alcohol withdrawal syndrome (AWS) in medical inpatients.

PATIENTS AND METHODS: This study was a retrospective analysis of patients admitted to general medical services between January 1, 1995, and December 31, 1998, who experienced AWS during the admission. This study was conducted at Saint Marys Hospital, Rochester, Minn. Patients were identified from hospital discharge diagnoses and pharmacy data. Symptom-triggered therapy for AWS was initiated in 1997. Patients were divided into preimplementation (1995-1996) and postimplementation (1997-1998) cohorts. Age, sex, medical comorbid conditions, previous AWS (including seizures and delirium tremens), duration of treatment for AWS, benzodiazepine use and dose, complications of AWS, and adverse outcomes of treatment during the incident admission were abstracted from the medical records of eligible patients. Comorbid conditions were classified according to the Charlson comorbidity index. Differences between the cohorts were assessed with use of logistic regression models and analysis of covariance.

RESULTS: Review of medical records from 638 admissions (536 patients) yielded 216 admissions eligible for this study. After adjustment for age, sex, Charlson comorbidity index, previous AWS, previous alcohol withdrawal seizures, and previous delirium tremens, we found no significant difference between cohorts for duration of treatment (P=.16), benzodiazepine use (P=.21), total dose of benzodiazepine (P=.38), or total complication rate (P=.053). We did observe a significant difference in the occurrence of delirium tremens between the 2 treatment groups (P=.04). This was especially apparent for patients with no history of delirium tremens.

CONCLUSIONS: Symptom-triggered therapy is effective treatment for AWS in medical inpatients. In this retrospective study, it did not result in shorter duration of treatment but was associated with a decreased occurrence of delirium tremens, the most severe and life-threatening complication of AWS. This result was most apparent in patients with no history of delirium tremens.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app