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Original Articles

Risk for delirium tremens in patients with alcohol withdrawal syndromeFootnote1

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Pages 83-94 | Published online: 13 Dec 2009
 

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% CI4.36–460). Elevated blood pressure, prior complicated alcohol withdrawal and medical comorbidity, alone and in combination, are associated with an increased risk of delirium tremens.

Notes

This work was presented at the Annual Meeting of the American Federation for Medical Research, April 25–27, 1997, Washington, DC, and the Robert Wood Johnson Clinical Scholars Program national meeting November 12–15, 1997.

Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut.

To whom correspondence should be addressed at Yale University School of Medicine, 333 Cedar Street, P.O. Box 208025, New Haven, Connecticut 06520–8025; e‐mail: [email protected].

Additional information

Notes on contributors

David A. Fiellin

2 3 4

Eric S. Holmboe

2 3

Ralph I. Horwitz

2 3

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