RT Journal Article
SR Electronic
T1 Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e001047
DO 10.1136/tsaco-2022-001047
VO 8
IS 1
A1 Tyler J Jones
A1 Bishwajit Bhattacharya
A1 Kevin M Schuster
A1 Robert D Becher
A1 Lisa M Kodadek
A1 Kimberly A Davis
A1 Adrian A Maung
YR 2023
UL http://tsaco.bmj.com/content/8/1/e001047.abstract
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.