Risk factors associated with complicated alcohol withdrawal syndrome

Background: Alcohol withdrawal syndrome (AWS) is a frequent presentation in patients with alcohol dependence syndrome. Complicated alcohol withdrawal state (i.e., delirium and/or convulsions) is the most severe form with significant morbidity and mortality if left untreated. Therefore, it is imperative to identify the risk factors associated with complicated AWS for early diagnosis and swift management. Materials and Methods: This study utilized a cross sectional design in a tertiary care center on 60 patients to identify the risk factors associated with complicated alcohol withdrawal. The data collected were subsequently subjected to statistical analysis with appropriate tests (Pearson Chi-square test, t-test). Results: Out of the 60 patients, 30 developed complicated AWS. Amongst the demographic variables, patients with education <10th standard, unemployment and history of delirium tremens were found to be significant predictors of complicated AWS. Patients with complicated AWS consumed higher mean ± standard deviation (19.33 ± 1.77 vs. 11.87 ± 1.17) units of alcohol per day (P < 0.001). The duration of alcohol withdrawal lasted for 7.13 ± 4.17 days in complicated AWS compared to 5.23 ± 2.70 days in uncomplicated (P = 0.041). Tacycardia (P = 0.001), respiratory rate (P = 0.001), low platelet count (P < 0.001) and higher Erythrocyte sedimentaion rate (P < 0.001) were also found to be significant predictors of complicated AWS. Serum gamma-glutamyl transferase GGT values were higher in complicated AWS but the difference was not statistically significant. Conclusion: This study found lower education, unemployment, history of delirium tremens, higher units of alcohol consumed per day, tacycardia, higher respiratory rate, lower platelet count and higher erythrocyte sedimentaion rate as significant predictors of complicated AWS.