Manifestations and clinical course of delirium tremens in the ICU

Oviedo, JA Camacho; Soriano, Cruz; Gómez, J Jiménez; Fuciños, L. Cachafeiro; Fonseca, Martha; Hernandez, R Garcia; Lendinez, M Jimenez

doi:10.1186/cc8727

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“…Data on the long-term outcomes of ICU patients with AWS are limited. In a Spanish study, 72% of ICU patients with delirium tremens were readmitted multiple times to the emergency department within the next 2 years [ 40 ]. Although AWS is by definition an acute syndrome, a quarter of our patients had persistent confusion at ICU discharge, more than 40% were unable to return home at hospital discharge, and 7% died within 28 days of ICU admission.…”

Section: Discussionmentioning

confidence: 99%

Alcohol withdrawal syndrome in ICU patients: Clinical features, management, and outcome predictors

et al. 2021

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Background Alcohol withdrawal syndrome (AWS) is a common condition in hospitalized patients, yet its epidemiology in the ICU remains poorly characterized. Methods Retrospective cohort of patients admitted to the Nantes University Hospital ICU between January 1, 2017, and December 31, 2019, and coded for AWS using ICD-10 criteria. The objective of the study was to identify factors associated with complicated hospital stay defined as ICU length of stay ≥7 days or hospital mortality. Results Among 5,641 patients admitted to the ICU during the study period, 246 (4.4%) were coded as having AWS. Among them, 42 had exclusion criteria and 204 were included in the study. The three main reasons for ICU admission were sepsis (29.9%), altered consciousness (29.4%), and seizures (24%). At ICU admission, median Cushman’s score was 6 [4–9] and median SOFA score was 3 [2–6]. Delirium tremens occurred in half the patients, seizures in one fifth and pneumonia in one third. Overall, 48% of patients developed complicated hospital stay, of whom 92.8% stayed in the ICU for ≥7 days, 36.7% received MV for ≥7 days, and 16.3% died during hospital stay. By multivariable analysis, two factors were associated with complicated hospital stay: a higher number of organ dysfunctions at ICU admission was associated with a higher risk of complicated hospital stay (OR, 1.18; 95CI, 1.05–1.32, P = 0.005), whereas ICU admission for seizures was associated with a lower risk of complicated hospital stay (OR, 0.14; 95%CI, 0.026–0.80; P = 0.026). Conclusions AWS in ICU patients chiefly affects young adults and is often associated with additional factors such as sepsis, trauma, or surgery. Half the patients experienced an extended ICU stay or death during the hospital stay. The likelihood of developing complicated hospital stay relied on the reason for ICU admission and the number of organ dysfunctions at ICU admission.

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Section: Discussionmentioning

confidence: 99%