Objective predictors for delirium tremens based on physiological and metabolic parameters

Abstract

BACKGROUND: The search for markers and predictors of complicated forms of alcoholism, which include alcoholic delirium and acute psychotic reactions with hallucinatory and delusional phenomena, is one of the actual problems of modern addiction medicine. AIM: Clinical validation of a model for early detection of patients at high risk of developing complicated alcohol withdrawal syndrome (AWS) based on laboratory diagnostics. SUBJECTS AND METHODS: A prospective, cohort, observational study was performed. The study included 200 patients; 9 were excluded. The included patients were distributed as follows: uncomplicated AWS, 98 patients (51.3%); alcohol delirium, 67 patients (35.1%); and alcohol-induced psychotic disorder, 26 patients (13.6%). Potassium, sodium, calcium, and platelet count were compared between the groups, and the relationships between sex, age, and potassium levels in patients with alcohol delirium were studied. RESULTS: Potassium, sodium, and platelet count were significantly different in patients with alcohol delirium and in those with uncomplicated AWS and alcohol-induced psychotic disorder. Blood calcium levels were significantly different between patients with alcohol delirium and uncomplicated AWS. Women were found to be less sensitive to metabolic disorders that developed as a result of alcohol consumption, as evidenced by lower incidence of delirium. The high prevalence of alcohol delirium among older patients is a consequence of decompensation of metabolic regulation mechanisms. CONCLUSIONS: Predictive model of alcohol delirium, based on the results of blood potassium level study, proved effectiveness in clinical application.