Course of alcohol withdrawal syndrome in a general hospital

Authors

  • Rafael Monte Secades Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo. Enviar correspondencia a: Rafael Monte Secades. Consulta de Medicina Interna nº 3. Complexo Hospitalario Xeral-Calde. Severo Ochoa s/n. 27004 Lugo. Tel.: 680 981 300
  • Ramón Rabuñal Rey Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo.
  • Fátima Paz Fuentes Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo.
  • Ana Pazos Ferro Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo.
  • Sonia Pértega Díaz Unidad de Epidemiología. Hospital Juan Canalejo, A Coruña.
  • Mercedes Bal Alvaredo Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo.
  • Emilio Casariego Vales Servicio de Medicina Interna. Complexo Hospitalario Xeral-Calde, Lugo.

DOI:

https://doi.org/10.20882/adicciones.203

Keywords:

alcohol withdrawal, delirium tremens, timing, hospitalization

Abstract

Introduction and objective: There is little information available regarding the course of alcohol withdrawal syndrome in a general hospital. The aim of this study was to analyse the timing of the most important clinical features attributed to alcohol withdrawal, as well as their prognostic implications. Material and method: A cohort study of patients with a diagnosis of alcohol withdrawal syndrome was carried out at the Xeral Hospital in Lugo (Spain) between 1987 and 2003, in accordance with DSM IV-TR criteria. Data on clinical characteristics and course were collected, with special attention to the timing of significant events. Results: A total of 539 episodes were studied in 436 patients: 156 cases of alcohol withdrawal syndrome and 383 of alcohol withdrawal delirium. Mean time of abstinence until the diagnosis of alcohol withdrawal syndrome was 54 hours (D.T. = 31.1). Seizures occurred at 35 hours (D.T. = 23.3) after abstinence. The alcohol withdrawal syndrome lasted for 46.4 hours (D.T. = 23.1) after diagnosis. In cases in which delirium tremens developed, this occurred at 46.4 hours (D.T. = 23.1), and lasted 73.9 hours (D.T. = 41.5). Patients needing intensive care were admitted to the ICU 40.8 hours (D.T. = 60) after the diagnosis of alcohol withdrawal syndrome. The clinical features of alcohol withdrawal syndrome tended to be more prolonged in patients admitted with a medical or surgical diagnosis other than withdrawal syndrome than in those admitted because of withdrawal syndrome itself. Conclusions: The natural history of alcohol withdrawal syndrome in a general hospital setting and the timings of its principal events follow a clearly recognizable pattern. This knowledge can help to provide better assessment in relation to the monitoring and treatment of these patients.

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Published

2010-06-01

Issue

Vol. 22 No. 2 (2010)

Section

Originals