PT  - JOURNAL ARTICLE
AU  - Tyler J Jones
AU  - Bishwajit Bhattacharya
AU  - Kevin M Schuster
AU  - Robert D Becher
AU  - Lisa M Kodadek
AU  - Kimberly A Davis
AU  - Adrian A Maung
TI  - Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File
AID  - 10.1136/tsaco-2022-001047
DP  - 2023 Mar 01
TA  - Trauma Surgery & Acute Care Open
PG  - e001047
VI  - 8
IP  - 1
4099  - http://tsaco.bmj.com/content/8/1/e001047.short
4100  - http://tsaco.bmj.com/content/8/1/e001047.full
SO  - Trauma Surg Acute Care Open2023 Mar 01; 8
AB  - Objective To identify the rates and possible predictors of alcohol withdrawal syndrome (AWS) among adult trauma patients.Methods This is a retrospective review of all adult patients (18 years or older) included in the 2017 and 2018 American College of Surgeons Trauma Quality Program Participant User File (PUF). The main outcomes were rates and predictors of AWS.Results 1 677 351 adult patients were included in the analysis. AWS was reported in 11 056 (0.7%). The rate increased to 0.9% in patients admitted for more than 2 days and 1.1% in those admitted for more than 3 days. Patients with AWS were more likely to be male (82.7% vs. 60.7%, p<0.001), have a history of alcohol use disorder (AUD) (70.3% vs. 5.6%, p<0.001) and have a positive blood alcohol concentration (BAC) on admission (68.2% vs. 28.6%, p<0.001). In a multivariable logistic regression, history of AUD (OR 12.9, 95% CI 12.1 to 13.7), cirrhosis (OR 2.1, 95% CI 1.9 to 2.3), positive toxicology screen for barbiturates (OR 2.1, 95% CI 1.6 to 2.7), tricyclic antidepressants (OR 2.2, 95% CI 1.5 to 3.1) or alcohol (OR 2.5, 95% CI 2.4 to 2.7), and Abbreviated Injury Scale head score of ≥3 (OR 1.7, 95% CI 1.6 to 1.8) were the strongest predictors for AWS. Conversely, only 2.7% of patients with a positive BAC on admission, 7.6% with a history of AUD and 4.9% with cirrhosis developed AWS.Conclusion AWS after trauma was an uncommon occurrence in the patients in the PUF, even in higher-risk patient populations.Level of evidence IV: retrospective study with more than one negative criterion.Data are available upon reasonable request.