Most of them were married For that matter any psychotropic drugs causing CNS depression or any effecting stimulants will alter the withdrawal symptoms. Factor analysis reveals the existence of multidimensionality of alcohol withdrawal as measured with CIWA-Ar and we found three factors that can be named as delirious, autonomic and nonspecific factors. Statistical Analysis The collected data on patients was statistically analyzed, using statistical package for social sciences SPSS, Inc. Of the admissions reviewed, were included after application of the inclusion and exclusion criteria Table 1.

Previous studies comparing symptom-triggered and non—symptom-triggered dosing have shown mean differences of about 40 h in duration of benzodiazepine treatment between the 2 strategies. The results of the current study supported this observation, as fewer benzodiazepine types and fewer adjunctive medications were used for the post-protocol admissions. Introduction Alcohol withdrawal syndrome AWS is characterized by varied symptoms that range from mild to severe intensity depending on several factors including the quantity, frequency and duration of alcohol intake, and the number of prior withdrawal episodes, as well as individual differences in the vulnerability [ 1 — 4 ]. Two items of CIWA-Ar, namely, auditory disturbances and tactile disturbances were very infrequent in our sample 9. The standard detoxification protocol included thiamine supplementation, benzodiazepines either lorazepam or diazepam, and correction of fluids and electrolytes if any and other symptomatic treatment of associated conditions like dyspepsia or concurrent injury, wound, and infections. We examined the factor structure of the CIWA-Ar in a population of adult men hospitalized to a tertiary psychiatric institute for treatment of alcohol dependence.

The mean age of starting alcohol was Patients over 18 years of age were included if they had been admitted to the internal medicine service for a minimum stay of at least 24 h and if there was documentation in the chart of a presumed diagnosis of alcohol withdrawal. Most of them were married On alcohol-dependent male patients seeking treatment for alcohol withdrawal at stuey hours of abstinence.


Factor Structure of CIWA-Ar in Alcohol Withdrawal

Although there were fewer severe adverse outcomes of benzodiazepines in the post-protocol group than in the pre-protocol group, casee difference was not statistically significant.

Assessment of alcohol withdrawal: A comparison of rating scales for the alcohol-withdrawal syndrome. Adherence with symptom-triggered benzodiazepine dosing, as per CIWA-Ar scoring, was also inconsistent.

ciwa-ar case study

Alcohol withdrawal treatment manual. Detailed physical examination, mental status examination, and planned screening laboratory investigation were done to ensure conformity of study criteria. It is possible that the 2 study groups were fundamentally different, especially given that the post-protocol group appeared to have a more severe addiction history.

The shorter median duration of hospital stay for the post-protocol group 3. Timing in Relation to Implementation of Protocol; N o. The guided fixed-schedule dosing combined with CIWA-Ar—dictated, symptom-triggered caae may help to minimize the disadvantages of unguided combination dosing relative to symptom-triggered dosing alone. The primary outcome was the duration of benzodiazepine treatment for alcohol withdrawal, defined as the time difference in hours between the first and last doses given in hospital, including doses given in the emergency department.

The study was approved by the institutional review board. Therefore, three factors were retained, which captured The scree test for number of factors.

Evaluation of an Alcohol Withdrawal Protocol and a Preprinted Order Set at a Tertiary Care Hospital

The median duration of benzodiazepine treatment for alcohol withdrawal declined significantly after introduction of the combination protocol: The collected data on patients was statistically analyzed, using statistical package for social sciences SPSS, Inc. A second generation little jiffy. The mean number of fixed-schedule doses received after CIWA-Ar scores ciwa-xr consistently below 10 was 3.

It was developed from caase item clinical institute withdrawal assessment for alcohol and it has been studied across various geographic locations. To avoid bias in the results, these patients with early discontinuation were included in the analyses of secondary outcomes excluding total benzodiazepine dose and quality assurance outcomes.


Tools Sociodemographic Data Sheet. This was expected as alcohol withdrawal manifests by simultaneous involvement ciwx-ar all mechanisms rather than any mutually exclusive mechanism. To gain an understanding of the patterns of usage of the protocol and to assess potential hospital-wide functionality, data relating to quality assurance outcomes were collected.

Evaluation of an Alcohol Withdrawal Protocol and a Preprinted Order Set at a Tertiary Care Hospital

The CIWA-Ar protocol dictates the period for which monitoring is required and whether a benzodiazepine dose should be administered.

In our setup, we use CIWA-Ar as part of the measure for the management of alcohol withdrawal symptoms. Median time from diagnosis of alcohol withdrawal syndrome to ordering of alcohol withdrawal protocol h.

Quality Assurance Outcomes Patterns of usage of the protocol in the post-protocol group were reviewed for quality assurance Table 5.

ciwa-ar case study

Early discontinuation was defined in ciws-ar pre-protocol group on the basis of transfer or discharge from the internal medicine service while receiving active withdrawal treatment i. The chart review nature of this study introduced innate limitations in terms of potential bias and missing data. The most common reasons for exclusion were admission with seizure or seizure disorder unrelated to alcohol withdrawal, regular use of benzodiazepines before caae, and no doses of benzodiazepine after transfer out of the emergency department.

Symptoms usually present themselves within 6 to 24 hours after cessation of alcohol intake [ 56 ].