Prevalence and Associated Factors of Alcohol Withdrawal Delirium in Trauma Patients at a Tertiary Care Hospital in Lower Northeastern Thailand
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Abstract
Objective: To determine the prevalence and associated factors of alcohol withdrawal delirium among trauma patients with a history of alcohol consumption.
Methods: This study was a retrospective cross-sectional descriptive study conducted among 365 trauma patients with a history of alcohol consumption who were admitted to Sunpasitthiprasong Hospital, Ubon Ratchathani, between June 1, 2021 and June 1, 2024. Purposive sampling was employed. Data were obtained from medical records and analyzed using descriptive statistics and inferential statistics, including Pearson’s chi-square test or Fisher’s exact test, Independent Samples t-test, and the Mann–Whitney U test. In addition, a two-step logistic regression analysis and multivariate logistic regression (bivariate and multivariate analyses) were performed. A p-value < 0.05 was considered statistically significant.
Results: A total of 365 patients were included in the study, with a mean age of 48.8 ± 13.15 years; 95.1% were male. The majority had single-system injuries (67.7%), while 32.3% sustained multiple injuries. The prevalence of alcohol withdrawal delirium (Delirium tremens; F10.4) among trauma patients with a history of alcohol consumption was 41.1%. Risk factors significantly associated with this condition included a history of prior alcohol withdrawal delirium (aOR = 6.04, 95% CI 3.06 – 11.91) and a hospital stay of ≥7 days (aOR = 3.59, 95% CI 1.91 – 6.75). In contrast, protective factors included a history of alcohol withdrawal seizures (aOR = 0.34, 95% CI 0.19 – 0.62) and prior use of psychotropic medications (aOR = 0.28, 95% CI 0.12 – 0.63). Furthermore, patients with alcohol withdrawal delirium had more laboratory abnormalities compared to those with alcohol withdrawal without delirium (F10.3), including higher levels of Blood Urea Nitrogen (BUN) (p-value = 0.039), Creatinine (p-value = 0.037), and Potassium (p-value = 0.041), along with lower Bicarbonate (HCO₃) levels (p-value = 0.041). In addition, this group experienced longer hospital stays (median = 11 days, IQR 7 – 17).
Conclusions: Alcohol withdrawal delirium is a frequent complication in trauma patients with a history of alcohol use and is associated with multiple clinical and laboratory risk factors. Early screening and close monitoring of high-risk patients are essential for reducing complications and mitigating the healthcare burden.
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