Evaluation of the use of treatment of alcohol withdrawal guideline in inpatients at Nakornping Hospital
Keywords:
Alcohol withdrawal, Alcohol withdrawal guideline, Symptom-triggered regimenAbstract
Objective: To evaluate the result of alcohol withdrawal treatment guideline at Nakornping Hospital
Method: Retrospective study was conducted by reviewing inpatients medical records in patients who diagnosed with mental and behavioral disorder due to use of alcohol withdrawal state/ with delirium (ICD10: F10.3,F10.4) between 1 January 2019- 31 December 2020, total of 173 cases. Demographic data and alcohol withdrawal data were collected and analyzed by using descriptive statistics, ANOVA and Kruskal-Wallis test.
Result: There were three groups by completeness of using the guideline, “Not complete” guideline 101 cases, “Partial complete” guideline 33 cases and “Complete” guideline 39 cases. There were no statistically significant differences between three groups in demographic data and feature of alcohol withdrawal. Mean onset of alcohol withdrawal was 1 day (1, 1-7) after admission. Duration of recovery (period of onset alcohol withdrawal to AWS<5) was 5 days (5.4±2.5). Length of stay was 7 days (4, 2-25). Lorazepam dose and antipsychotic drugs usage were not statistically significant difference between three groups. Diazepam injection dosage between Not complete guideline and Partial complete guideline were significantly different (p-value 0.008). Ninety-two point five percent of the patients had comorbidities including delirium 139 cases (80.3%), electrolyte imbalance 131 cases (75.7%), seizure 20 cases (11.6%), the level of creatine phosphokinase (CPK) abnormally high 20 cases (11.6%). Between 2019-2020, the number of cases in “Not complete” guideline group decreased while the number of cases in “Complete” guideline group increased with statistically significant (p-value <0.001).
Conclusion: The use of alcohol withdrawal guideline tends to increase in this study. In this view, continuous encourage medical staffs in alcohol withdrawal knowledge and AWS evaluation for effectiveness in patient care process.
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