Evaluation of a Novel Protocol for Assessment and Treatment of Alcohol Withdrawal Syndrome in Psychiatric Inpatients.
Evaluation of a Novel Protocol for Assessment and Treatment of Alcohol Withdrawal Syndrome in Psychiatric Inpatients.
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DOI：
10.1111/ajad.13058
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Herschenhous N
中科院分区：
文献类型：
--
作者：
Butterfield M;Thorne-Humphrey L;Suzuki J;Herschenhous N
尽管精神科住院患者中酒精戒断综合征（AWS）的发病率很高，但在这一人群中，评估和治疗酒精戒断综合征的标准化方法以前只研究过一次。我们评估了一种为精神科住院患者设计的新颖的AWS评估和治疗方案。这项回顾性队列研究评估了方案实施前后的结果。我们收集了同一中心精神科住院病人（N = 138）的连续数据。参与者是因非药物相关精神原因入院的患者，他们也有发展为AWS的风险。发生AWS的患者接受(a)常规治疗（TAU）或(b)新的标准化治疗方案。主要结局是苯二氮卓类药物治疗酒精戒断症状的持续时间。次要结局包括累积苯二氮卓类药物剂量、治疗持续时间和并发症发生率。138名参与者中，83名接受了TAU治疗，55名接受了新方案的评估和治疗。方案实施后苯二氮卓类药物治疗的中位持续时间为实施前（TAU） 19.7小时（四分位数范围[IQR]， 0-46），方案组（方案组）实施后0小时（IQR, 0-15） （P < 0.0001）。给予参与者苯二氮卓的中位剂量（以地西泮当量计）为TAU组为30 mg (IQR, 0-65)，方案组为5 mg (IQR, 0-30) （P < .001）。实施前后不良事件发生率分别为4.8%和0% （P = 0.15）。本研究为精神科住院患者的新型标准化AWS方案的有效性和安全性提供了初步证据。这是第一项已知的研究，评估为精神科住院患者设计的AWS评估和治疗方案。
Despite the high incidence of alcohol withdrawal syndrome (AWS) in psychiatric inpatients, standardized methods for assessing and treating AWS have been studied only once before in this population. We evaluated a novel AWS assessment and treatment protocol designed for psychiatric inpatients. This retrospective cohort study evaluated outcomes before and after implementation of the protocol. We collected consecutive data on patients (N = 138) admitted to inpatient psychiatric units at a single center. Participants were patients admitted for nonsubstance-related psychiatric reasons, who were also at risk for developing AWS. Those who developed AWS were treated with either (a) treatment as usual (TAU) or (b) a novel standardized protocol. The primary outcome was duration of benzodiazepine treatment for symptoms of alcohol withdrawal. Secondary outcomes included cumulative benzodiazepine dose administered, treatment duration, and incidence of complications. Of 138 participants, 83 received TAU and 55 were assessed and treated with the novel protocol. Median duration of benzodiazepine treatment following protocol implementation was 19.7 hours (interquartile range [IQR], 0-46) prior to implementation (TAU) and 0 hours (IQR, 0-15) following protocol implementation (protocol group) (P < .0001). Median benzodiazepine dose (in diazepam equivalents) administered to participants was 30 mg (IQR, 0-65) for TAU and 5 mg (IQR, 0-30) for the protocol group (P < .001). Adverse events before and after implementation occurred in 4.8% and 0%, respectively (P = .15). This study provides preliminary evidence for the efficacy and safety of a novel standardized AWS protocol for psychiatric inpatients. This is the first known study assessing an AWS assessment and treatment protocol designed for psychiatric inpatients.
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影响因子：
120.7
作者：
SAITZ, R;MAYOSMITH, MF;CALKINS, DR
通讯作者：
CALKINS, DR
影响因子：
3.4
作者：
Repper-DeLisi, Jennifer;Stern, Theodore A.;Bierer, Michael
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作者：
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影响因子：
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作者：
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通讯作者：
Yersin, B
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作者：
Smothers, BA;Yahr, HT;Ruhl, CE
通讯作者：
Ruhl, CE