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Prevention of alcohol withdrawal by the use of the prediction of alcohol withdrawal severity scale in hospitalized patients


Gastroenterology & Hepatology: Open Access
Joanna Lenik, Jinendra Satiya, Tikal Kansara, Yoel Prince, Nora V Bergasa, Jonna Mercado

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Abstract

Background: Alcohol withdrawal (AW) is a serious complication of alcohol use disorder. We aimed to identify hospitalized patients at risk for AW using the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) Score and to treat then preventively. Objective of the study: Investigation of the value of the PAWSS for risk recognition and preventive treatment of AW in hospitalized patients. Methods and materials: A retrospective medical records review of hospitalized patients with a history of alcohol use admitted from December 1st of 2019 and April 30th of 2020, in whom the PAWSS had been completed. Exclusion criterion was AW on admission. A PAWSS score of 4 predicts AW. Demographics, comorbidities, pertinent laboratory results, PAWSS score, use of benzodiazepine, and hospital course were recorded. The exclusion criterion was alcohol withdrawal on admission. De-identified data were stored in a password protected drive only accessible to the members of the study team and deleted from the drive at the completion of data collection and analysis. The study was approved by the Institutional Review Board. Sample of the study included twenty- nine subjects. Chisquare statistics were used to calculate unadjusted associations between predictors and the symptom status outcome.
Results: Twenty-nine patients were identified. Of these, twenty had a PAWSS <4, and nine scored ≥4. Eight of the nine patients who scored ≥4 and were treated with a benzodiazepine three-day tapering dose institutional protocol did not develop AW; the patient who was not treated preventively developed withdrawal symptoms (Table. 1) Conclusion: Preventive treatment based on a PAWSS score within the realm that predicts AW prevents the development of this complication of AUD.
Recommendations: We propose the system-wide use of the PAWSS in all hospitalized patients with AUD

Keywords

alcohol use disorder, alcohol withdrawal, PAWSS, benzodiazepine, alanine aminotransferase, Hepatitis B,Hepatitis C

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