Alcohol withdrawal syndrome: Turning minor injuries into a major problem

Michael R. Bard, Claudia E. Goettler, Eric A. Toschlog, Scott G. Sagraves, Paul J. Schenarts, Mark A. Newell, Mark Fugate, Michael F. Rotondo

Research output: Contribution to journalReview article

34 Citations (Scopus)

Abstract

BACKGROUND: Abrupt cessation of chronic drinking patterns places hospitalized patients at risk for alcohol withdrawal syndrome (AWS). The purpose of this study was to investigate the effect of AWS on length of stay, morbidity, mortality, and cost in low injury acuity trauma patients. METHODS: A retrospective review of the National Trauma Registry of the American College of Surgeons database from July 1999 to February 2004 was performed. All patients 15 years or older admitted to our Level I trauma center with an Injury Severity Score (ISS) <16 were included. AWS patients were compared with those without AWS. Demographics, mechanism of injury (MOI), ISS, revised trauma score, Glasgow Coma score, hospital course, morbidity, requirement of additional procedures, mortality, and cost were compared. Analysis was done with χ test and Student's t test. A p value of ≤0.05 determined significance. RESULTS: Of 6,431 patients, 55 (0.9%) developed AWS. AWS patients were likely men (p < 0.001); had a higher ISS (p = 0.001) and lower Glasgow Coma score (p = 0.01); had more ventilator days (p = 0.008), intensive care unit days (p < 0.0001), and hospital days (p < 0.0001); suffered more complications, including respiratory failure (p < 0.0001), pneumonia (p < 0.0001), urinary tract infection (p = 0.0005), sepsis (p < 0.0001), tracheostomy (p < 0.0001), and percutaneous endoscopic gastrostomy (p < 0.0001); and had higher cost (p < 0.0001). Mortality was similar (p = 0.38) among groups. CONCLUSIONS: Low injury acuity patients with AWS have increased morbidity, leading to increased hospital stay and cost. To allow minor injuries to remain minor problems, the best modality to identify patients at risk and to achieve AWS prophylaxis require further investigation.

Original languageEnglish (US)
Pages (from-to)1441-1445
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume61
Issue number6
DOIs
StatePublished - Dec 1 2006

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Alcohols
Wounds and Injuries
Injury Severity Score
Patient Acuity
Coma
Morbidity
Costs and Cost Analysis
Mortality
Length of Stay
Gastrostomy
Hospital Costs
Trauma Centers
Tracheostomy
Mechanical Ventilators
Urinary Tract Infections
Respiratory Insufficiency
Drinking
Intensive Care Units
Registries
Sepsis

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Alcohol withdrawal syndrome : Turning minor injuries into a major problem. / Bard, Michael R.; Goettler, Claudia E.; Toschlog, Eric A.; Sagraves, Scott G.; Schenarts, Paul J.; Newell, Mark A.; Fugate, Mark; Rotondo, Michael F.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 61, No. 6, 01.12.2006, p. 1441-1445.

Research output: Contribution to journalReview article

Bard, MR, Goettler, CE, Toschlog, EA, Sagraves, SG, Schenarts, PJ, Newell, MA, Fugate, M & Rotondo, MF 2006, 'Alcohol withdrawal syndrome: Turning minor injuries into a major problem', Journal of Trauma - Injury, Infection and Critical Care, vol. 61, no. 6, pp. 1441-1445. https://doi.org/10.1097/01.ta.0000245981.22931.43
Bard, Michael R. ; Goettler, Claudia E. ; Toschlog, Eric A. ; Sagraves, Scott G. ; Schenarts, Paul J. ; Newell, Mark A. ; Fugate, Mark ; Rotondo, Michael F. / Alcohol withdrawal syndrome : Turning minor injuries into a major problem. In: Journal of Trauma - Injury, Infection and Critical Care. 2006 ; Vol. 61, No. 6. pp. 1441-1445.
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abstract = "BACKGROUND: Abrupt cessation of chronic drinking patterns places hospitalized patients at risk for alcohol withdrawal syndrome (AWS). The purpose of this study was to investigate the effect of AWS on length of stay, morbidity, mortality, and cost in low injury acuity trauma patients. METHODS: A retrospective review of the National Trauma Registry of the American College of Surgeons database from July 1999 to February 2004 was performed. All patients 15 years or older admitted to our Level I trauma center with an Injury Severity Score (ISS) <16 were included. AWS patients were compared with those without AWS. Demographics, mechanism of injury (MOI), ISS, revised trauma score, Glasgow Coma score, hospital course, morbidity, requirement of additional procedures, mortality, and cost were compared. Analysis was done with χ test and Student's t test. A p value of ≤0.05 determined significance. RESULTS: Of 6,431 patients, 55 (0.9{\%}) developed AWS. AWS patients were likely men (p < 0.001); had a higher ISS (p = 0.001) and lower Glasgow Coma score (p = 0.01); had more ventilator days (p = 0.008), intensive care unit days (p < 0.0001), and hospital days (p < 0.0001); suffered more complications, including respiratory failure (p < 0.0001), pneumonia (p < 0.0001), urinary tract infection (p = 0.0005), sepsis (p < 0.0001), tracheostomy (p < 0.0001), and percutaneous endoscopic gastrostomy (p < 0.0001); and had higher cost (p < 0.0001). Mortality was similar (p = 0.38) among groups. CONCLUSIONS: Low injury acuity patients with AWS have increased morbidity, leading to increased hospital stay and cost. To allow minor injuries to remain minor problems, the best modality to identify patients at risk and to achieve AWS prophylaxis require further investigation.",
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AU - Bard, Michael R.

AU - Goettler, Claudia E.

AU - Toschlog, Eric A.

AU - Sagraves, Scott G.

AU - Schenarts, Paul J.

AU - Newell, Mark A.

AU - Fugate, Mark

AU - Rotondo, Michael F.

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N2 - BACKGROUND: Abrupt cessation of chronic drinking patterns places hospitalized patients at risk for alcohol withdrawal syndrome (AWS). The purpose of this study was to investigate the effect of AWS on length of stay, morbidity, mortality, and cost in low injury acuity trauma patients. METHODS: A retrospective review of the National Trauma Registry of the American College of Surgeons database from July 1999 to February 2004 was performed. All patients 15 years or older admitted to our Level I trauma center with an Injury Severity Score (ISS) <16 were included. AWS patients were compared with those without AWS. Demographics, mechanism of injury (MOI), ISS, revised trauma score, Glasgow Coma score, hospital course, morbidity, requirement of additional procedures, mortality, and cost were compared. Analysis was done with χ test and Student's t test. A p value of ≤0.05 determined significance. RESULTS: Of 6,431 patients, 55 (0.9%) developed AWS. AWS patients were likely men (p < 0.001); had a higher ISS (p = 0.001) and lower Glasgow Coma score (p = 0.01); had more ventilator days (p = 0.008), intensive care unit days (p < 0.0001), and hospital days (p < 0.0001); suffered more complications, including respiratory failure (p < 0.0001), pneumonia (p < 0.0001), urinary tract infection (p = 0.0005), sepsis (p < 0.0001), tracheostomy (p < 0.0001), and percutaneous endoscopic gastrostomy (p < 0.0001); and had higher cost (p < 0.0001). Mortality was similar (p = 0.38) among groups. CONCLUSIONS: Low injury acuity patients with AWS have increased morbidity, leading to increased hospital stay and cost. To allow minor injuries to remain minor problems, the best modality to identify patients at risk and to achieve AWS prophylaxis require further investigation.

AB - BACKGROUND: Abrupt cessation of chronic drinking patterns places hospitalized patients at risk for alcohol withdrawal syndrome (AWS). The purpose of this study was to investigate the effect of AWS on length of stay, morbidity, mortality, and cost in low injury acuity trauma patients. METHODS: A retrospective review of the National Trauma Registry of the American College of Surgeons database from July 1999 to February 2004 was performed. All patients 15 years or older admitted to our Level I trauma center with an Injury Severity Score (ISS) <16 were included. AWS patients were compared with those without AWS. Demographics, mechanism of injury (MOI), ISS, revised trauma score, Glasgow Coma score, hospital course, morbidity, requirement of additional procedures, mortality, and cost were compared. Analysis was done with χ test and Student's t test. A p value of ≤0.05 determined significance. RESULTS: Of 6,431 patients, 55 (0.9%) developed AWS. AWS patients were likely men (p < 0.001); had a higher ISS (p = 0.001) and lower Glasgow Coma score (p = 0.01); had more ventilator days (p = 0.008), intensive care unit days (p < 0.0001), and hospital days (p < 0.0001); suffered more complications, including respiratory failure (p < 0.0001), pneumonia (p < 0.0001), urinary tract infection (p = 0.0005), sepsis (p < 0.0001), tracheostomy (p < 0.0001), and percutaneous endoscopic gastrostomy (p < 0.0001); and had higher cost (p < 0.0001). Mortality was similar (p = 0.38) among groups. CONCLUSIONS: Low injury acuity patients with AWS have increased morbidity, leading to increased hospital stay and cost. To allow minor injuries to remain minor problems, the best modality to identify patients at risk and to achieve AWS prophylaxis require further investigation.

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