SHM Converge Scientific Abstract ePoster Gallery-Type of Alcohol Withdrawal Severity Scale and Hospital Outcomes: A Multicenter Cohort Study

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This multicenter retrospective cohort study examined whether alcohol withdrawal severity scales that include vital signs lead to different hospital outcomes than the commonly used CIWA-Ar scale. The study included patients hospitalized for alcohol withdrawal on medical and surgical wards across 19 Veterans Health Administration hospitals from October 2018 to September 2019.<br /><br />The main outcomes were treatment duration and complicated withdrawal. Patients were monitored either with CIWA-Ar or with scales incorporating vital signs, including SEWS, MINDS, and AWS. Researchers adjusted for demographics, comorbidities, prior withdrawal history, ICU admission, blood pressure, treatment approach, and medication type.<br /><br />Among 588 patients, 461 were managed with CIWA-Ar and 127 with vital-sign-based scales. Patients in the two groups were broadly similar, though those monitored with vital-sign scales had more acute medical need and a different comorbidity profile.<br /><br />Key findings:<br />- Treatment lasted longer when vital-sign-based scales were used.<br />- Mean treatment duration was 3.4 days with CIWA-Ar versus 3.9 days with vital-sign-based scales.<br />- After multivariable adjustment, use of vital-sign scales remained associated with longer treatment duration (adjusted relative risk 1.30, 95% CI 1.15–1.48).<br />- There was no difference in complicated withdrawal between scale types (adjusted odds ratio 1.00, 95% CI 0.41–2.45).<br /><br />The authors concluded that alcohol withdrawal scales incorporating vital signs were associated with longer treatment without reducing complicated withdrawal. They do not support routine use of these scales based on the available data and suggest that randomized clinical trials are needed to determine the best severity scale.

Asset Subtitle

Jeydith Gutierrez

Meta Tag

Author List Andrea Roberts, Andrea Smeraglio, Craig Gunderson, Daniel Heppe, Erik Ehlers, Jaclyn Vargas, Jessica Cyr, Jeydith Gutierrez, Joel C. Boggan, Joel Elzweig, Matthew Ronan, Matthew Tuck, Meghna Shah, Meredith Trubitt, Micah Pescetto, Michael Krug, Miche

Category Research

Concept CIWA

Concept Alcohol Withdrawal

Concept Vital Signs

Concept Complicated Alcohol Withdrawal

Concept Severity Scale

Distinguished Non-Finalist

Presenter Organization University of Iowa School of Medicine

Presenting Author Jeydith Gutierrez

Track Other

Keywords

alcohol withdrawal

CIWA-Ar

vital signs

hospital outcomes

retrospective cohort

multicenter study

treatment duration

complicated withdrawal

Veterans Health Administration

withdrawal severity scales

CIWA

Alcohol Withdrawal

Vital Signs

Complicated Alcohol Withdrawal

Severity Scale