Substance Abuse

, Volume 23, Issue 2, pp 83–94

Risk for Delirium Tremens in Patients with Alcohol Withdrawal Syndrome

Authors

  • David A. Fiellin
    • Department of Internal MedicineYale University School of Medicine
    • Robert Wood Johnson Clinical Scholars ProgramYale University School of Medicine
  • Patrick G. O'Connor
    • Department of Internal MedicineYale University School of Medicine
  • Eric S. Holmboe
    • Department of Internal MedicineYale University School of Medicine
    • Robert Wood Johnson Clinical Scholars ProgramYale University School of Medicine
  • Ralph I. Horwitz
    • Department of Internal MedicineYale University School of Medicine
    • Robert Wood Johnson Clinical Scholars ProgramYale University School of Medicine
Article

DOI: 10.1023/A:1015350005418

Cite this article as:
Fiellin, D.A., O'Connor, P.G., Holmboe, E.S. et al. Subst Abus (2002) 23: 83. doi:10.1023/A:1015350005418
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Abstract

To determine the characteristics associated with an increased risk for delirium tremens (DT) we performed a case-control study at the detoxification units of two hospitals. Cases met DSM-IV criteria for DT. For each case (n = 15), 3 controls (n = 45) were chosen. Eligibility criteria were applied equally to cases and controls. Cases were more likely than controls to report a prior complicated withdrawal (DT or alcohol withdrawal seizure) (53 vs. 27%, OR 3.1, 95% CI 0.94–10.55), have a systolic blood pressure greater than 145 mm Hg on admission (60 vs. 27%, OR 4.1, 95% CI 1.21–14.06), and have comorbidity scores of at least 1 (60 vs. 18%, OR 6.9, 95% CI 1.92–25.08). Zero cases (0%) and 15 (33%) controls had no prior complicated withdrawals and no adverse clinical features (systolic blood pressure >145 or comorbidity score >1). Compared to this group, the odds of being a case and having both prior complicated withdrawal and at least 1 adverse clinical feature was 44.8 (95% CI 4.36–460). Elevated blood pressure, prior complicated alcohol withdrawal and medical comorbidity, alone and in combination, are associated with an increased risk of delirium tremens.

alcohol withdrawal deliriumdelirium tremenssubstance withdrawal syndromecase-control studiesprognosiscomorbidity

Copyright information

© Association for Medical Education and Research in Substance Abuse 2002