Predictors of severe alcohol withdrawal state in hospitalised patients


  • Катерина Юріївна Бєлка Bogomolets National Medical University 13 Shevchenko bul., Kyiv, Ukraine, 01601 Сlinic “Boris” 12а M. Bajana ave., Kyiv, Ukraine, 02140, Ukraine



alcohol withdrawal syndrome, risk factors, predictors, intensive care, alcohol abuse


The objective of this study was to develop a prediction model for severe alcohol withdrawal syndrome (AWS) in hospitalized AWS patients.

Methods: 336 patients were admitted to this observational prospective study. Multivariable binary regression models with stepwise selection procedures were conducted providing odds ratio (OR) estimates.

Results: In the multivariable regression, significant predictors of severe AWS were: history of AWS [OR: 29; 95 % confidence interval (CI): 14–68; p=0,001]; history of AWS seizures [OR 4; 95 % CI: 1,3–16; p=0,008]; history of other psychoactive drugs (e.g. benzodiazepines, opioids) used [OR 3; 95 % CI: 1,3–10; p=0,04]; tachycardia [OR 5; 95 % CI: 3–11; p=0,0001]; trombocitopenia [OR 3; 95 % CI: 1,5–7]; liver cirrhosis class B [OR 8; 95 % CI: 1,1–344; p=0,04] or C by Child-Pugh [OR 4; 95 % CI: 1,1–21; p=0,03].

Conclusions: In this large prospective study we determine the predictors of severe AWS course in hospitalized patients, they are: history of AWS or AWS seizures, history of other psychoactive drugs (e.g. benzodiazepines, opioids) used, trombocitopenia, liver cirrhosis class B or C by Child-Pugh

Author Biography

Катерина Юріївна Бєлка, Bogomolets National Medical University 13 Shevchenko bul., Kyiv, Ukraine, 01601 Сlinic “Boris” 12а M. Bajana ave., Kyiv, Ukraine, 02140


Anesthesiology and intensive care department


Аnesthesiology and intensive care department


Kanny, D., Liu, Y., Brewer, R. D. et. al (2012). Vital signs: Binge drinking prevalence, frequency, and intensity among adults – United States, 2010. MMWR, 61, 14–19.

Sarff, M., Gold, J. A. (2010). Alcohol withdrawal syndromes in the intensive care unit. Critical Care Medicine, 38, 494–501. doi: 10.1097/ccm.0b013e3181ec5412

Hillemacher, T., Frieling, H., Wilhelm, J., Heberlein, A., Karagülle, D., Bleich, S. et. al. (2012). Indicators for elevated risk factors for alcohol-withdrawal seizures: an analysis using a random forest algorithm. Journal of Neural Transmission, 119 (11), 1449–1453. doi: 10.1007/s00702-012-0825-8

Eyer, F., Schuster, T., Felgenhauer, N., Pfab, R., Strubel, T., Saugel, B., Zilker, T. (2011). Risk Assessment of Moderate to Severe Alcohol Withdrawal – Predictors for Seizures and Delirium Tremens in the Course of Withdrawal. Alcohol and Alcoholism, 46 (4), 427–433. doi: 10.1093/alcalc/agr053

Larson, S. A., Burton, M. C., Kashiwagi, D. T., Hugo, Z. P., Cha, S. S., Lapid, M. I. (2012). Multiple admissions for alcohol withdrawal. Journal of Hospital Medicine, 7 (8), 617–621. doi: 10.1002/jhm.1953

Ramos, R., Mallet, T., Divittis, A., Cohen, R. (2013). Predictors of severity of alcohol withdrawal in hospitalized patients. Journal of Clinical Medicine Research, 5 (5), 376–380. doi: 10.4021/jocmr1514w

Goodson, C. M., Clark, B. J., Douglas, I. S. (2014). Predictors of Severe Alcohol Withdrawal Syndrome: A Systematic Review and Meta-Analysis. Alcoholism: Clinical and Experimental Research, 38 (10), 2664–2677. doi: 10.1111/acer.12529

Kim, D. W., Kim, H. K., Bae, E.-K., Park, S.-H., Kim, K. K. (2015). Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures. The American Journal of Emergency Medicine, 33 (5), 701–704. doi: 10.1016/j.ajem.2015.02.030

Shu, J. E., Lin, A., Chang, G. (2015). Alcohol Withdrawal Treatment in the Medically Hospitalized Patient: A Pilot Study Assessing Predictors for Medical or Psychiatric Complications. Psychosomatics, 56 (5), 547–555. doi: 10.1016/j.psym.2014.12.002

Karila, L., Zarmdini, R., Lejoyeux, M. (2014). Delirium tremens. Rev. Prat., 64 (10), 1349–1352.





Medical Science. Part 2