Abstract
| Original language | English |
|---|---|
| Journal | Drugs and Alcohol today |
| DOIs | |
| Publication status | Published - 10 Jun 2019 |
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Keywords
- Alcohol
- Alcohol withdrawal syndrome
- Alcohol-related seizures
- Delirium tremens
- General hospital
- Hospital admission
- Risk prediction
- Risk stratification
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Development of an Alcohol Withdrawal risk stratification tool based on patients referred to an addiction liaison nursing service in Glasgow. / Benson, George; McPherson, Andrew; McCallum, Jacqueline; Roberts, Nicola.
In: Drugs and Alcohol today, 10.06.2019.Research output: Contribution to journal › Article
TY - JOUR
T1 - Development of an Alcohol Withdrawal risk stratification tool based on patients referred to an addiction liaison nursing service in Glasgow
AU - Benson, George
AU - McPherson, Andrew
AU - McCallum, Jacqueline
AU - Roberts, Nicola
N1 - Acceptance in SAN AAM version queried 30/04/19 DC; author highlighted point in publisher email where they consider the attached the AAM. ET 1/5/19 AAM: no embargo upon publication Added pre-pub embargo end date. ET 30/10/19
PY - 2019/6/10
Y1 - 2019/6/10
N2 - Purpose: The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department. Design/methodology/approach: A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population. Findings: The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively. Research limitations/implications: The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score. Practical implications: The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life. Originality/value: The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.
AB - Purpose: The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department. Design/methodology/approach: A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population. Findings: The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively. Research limitations/implications: The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score. Practical implications: The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life. Originality/value: The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.
KW - Alcohol
KW - Alcohol withdrawal syndrome
KW - Alcohol-related seizures
KW - Delirium tremens
KW - General hospital
KW - Hospital admission
KW - Risk prediction
KW - Risk stratification
U2 - 10.1108/DAT-02-2019-0009
DO - 10.1108/DAT-02-2019-0009
M3 - Article
ER -