Alcohol Withdrawal Syndrome in Women vs Men: Analysis of 1496 Cases at a Single Site

Author:

Canales Francisco J.1,Davis Jesse2,Girgla Navkaran3,Emami Maryam4,Cooper Tracy5,Carlson Richard W.6

Affiliation:

1. Francisco J. Canales Jr is a resident physician, Department of Emergency Medicine, University of Arizona, Tucson.

2. Jesse Davis is a resident physician, Department of Medicine, Valleywise Medical Center, Phoenix, Arizona, and Creighton University Arizona Education Health Alliance, Phoenix.

3. Navkaran Girgla is a resident physician, Department of Medicine, Valleywise Medical Center, and Creighton University Arizona Education Health Alliance.

4. Maryam Emami is a staff physician, Thumb Butte Medical Center, Prescott, Arizona.

5. Tracy Cooper is a staff nurse in the intensive care unit, Valleywise Medical Center.

6. Richard W. Carlson is a professor, College of Medicine, University of Arizona, Phoenix, and Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, and chair emeritus, Department of Medicine, Valleywise Health Medical Center.

Abstract

Background Studies of alcohol withdrawal syndrome indicate a higher prevalence in men than in women. However, it is unknown how the condition differs between the sexes. Objective To assess alcohol withdrawal syndrome in women versus men at a single site. Methods All cases of alcohol withdrawal syndrome at a public hospital from 2010 to 2014 were reviewed retrospectively. For all 1496 episodes, age, sex, and admission to a general care unit (ward) versus the medical intensive care unit were ascertained, along with patient survival. A detailed analysis was performed of 437 cases: all 239 patients admitted to the medical intensive care unit, all 99 female patients admitted to the ward, and 99 randomly selected male patients admitted to the ward. Also analyzed were administration of benzodiazepines, disease course, length of stay, and complications. Results Men accounted for 92% of all cases (1378 of 1496; P < .001) and medical intensive care unit admissions (220 of 239; P < .05). Sixteen percent of both men and women were admitted to the medical intensive care unit. Men were older (mean age, 45.6 vs 43.9 years; P < .01), and women required more benzodiazepines. Similar rates of complications occurred in both sexes, although women had a higher rate of pancreatitis and men had higher rates of pneumonia, higher rates of sepsis, and longer stays. Conclusions Men and women with alcohol withdrawal syndrome have similar complications, courses, and intensive care unit admission rates, although men are more prone to pneumonia and have longer stays.

Publisher

AACN Publishing

Subject

Critical Care Nursing,General Medicine

Reference64 articles.

1. National Institute on Alcohol Abuse and Alcoholism. 10th Special Report to the US Congress on Alcohol and Health: Highlights From Current Research. National Institutes of Health; June 2000. Accessed March 20, 2018. https://pubs.niaaa.nih.gov/publications/10report/10thspecialreport.pdf

2. Global burden of disease and injury and economic costs attributable to alcohol use and alcohol-use disorders;Rehm;Lancet,2009

3. Alcohol withdrawal syndromes in the intensive care unit;Sarff;Crit Care Med,2010

4. Alcohol withdrawal and delirium tremens in the critically ill: a systematic review and commentary;Awissi;Intensive Care Med,2013

5. Predictors of severe alcohol withdrawal syndrome: a systematic review and meta-analysis;Goodson;Alcohol Clin Exp Res,2014

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