Predictors of Seizures and Delirium Tremens in the Course of Alcohol Withdrawal
Identifying predictors of alcohol withdrawal seizures (AWS) and delirium tremens (DTs) among patients hospitalized for alcohol withdrawal could be helpful to clinicians. Researchers in Germany retrospectively studied a cohort of 827 adult patients admitted to a hospital intensive-care unit for alcohol detoxification (elective and emergency admissions). All patients received score-guided treatment with clomethiazole started simultaneously with an antiepileptic (valproic acid or carbamazepine) as well as clonidine when noradrenergic hyperactivity was present and haloperidol when there were hallucinations. The researchers used stepwise logistic regression models to identify predictors of AWS and DTs.
- Of the 827 patients, 5.6% had DTs and 7.4% had AWS.
- Significant predictors of AWS, independent of medication administered, were past structural brain lesions* (odds ratio [OR], 6.5), AWS as the cause of admission (OR, 2.6), and delayed peak of withdrawal severity since admission (OR for every 10-hour increase, 1.23).
- Significant predictors of DTs, independent of medication administered, were past structural brain lesions (OR, 5.8), lower platelet count (OR per increase of 100.000, 0.42), and lower serum potassium level (OR per increase of 1 mmol/l, 0.33).