Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center
OBJECTIVES: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol.
METHODS: This single-center, retrospective, observational, cohort study assessed patients ordered the BAWS protocol between August 1, 2016 and July 31, 2017. Data were collected on benzodiazepine exposure, duration of treatment, withdrawal severity, agitation, over-sedation, and delirium while being treated for alcohol withdrawal. Comparisons were made to analyze predetermined patient subgroups.
RESULTS: Seven hundred ninety-nine patients were initiated on the BAWS protocol. Patients received a median (IQR) of 0 (0-4) lorazepam equivalents (LEs) and were on the BAWS protocol for a median (IQR) of 44.9 (22.4-77.2) hours. Of the patients that received benzodiazepines while on the BAWS protocol, a median (IQR) of 4 (2-11) LEs were given. Seventeen (2.1%) patients had severe withdrawal. Days of agitation, over-sedation, and delirium were minimal, with the median (IQR) of 0 (0-0). Few patients received adjunctive medications for symptom management. Intensive care unit (ICU) patients had more severe withdrawal than non-ICU patients, but received the same cumulative benzodiazepine dose.
CONCLUSIONS: Most patients on the BAWS protocol received little-to-no benzodiazepines; severe withdrawal, agitation, delirium, or over-sedation were uncommon. This is the first evaluation of the BAWS protocol on a diverse population of hospitalized patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Journal of addiction medicine - 13(2019), 5 vom: 20. Sept., Seite 379-384 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lindner, Brian K [VerfasserIn] |
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| Links: |
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| Themen: |
12794-10-4 |
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| Anmerkungen: |
Date Completed 29.07.2020 Date Revised 29.07.2020 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/ADM.0000000000000510 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM293676860 |
|---|
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| 100 | 1 | |a Lindner, Brian K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center |
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| 500 | |a Date Completed 29.07.2020 | ||
| 500 | |a Date Revised 29.07.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol | ||
| 520 | |a METHODS: This single-center, retrospective, observational, cohort study assessed patients ordered the BAWS protocol between August 1, 2016 and July 31, 2017. Data were collected on benzodiazepine exposure, duration of treatment, withdrawal severity, agitation, over-sedation, and delirium while being treated for alcohol withdrawal. Comparisons were made to analyze predetermined patient subgroups | ||
| 520 | |a RESULTS: Seven hundred ninety-nine patients were initiated on the BAWS protocol. Patients received a median (IQR) of 0 (0-4) lorazepam equivalents (LEs) and were on the BAWS protocol for a median (IQR) of 44.9 (22.4-77.2) hours. Of the patients that received benzodiazepines while on the BAWS protocol, a median (IQR) of 4 (2-11) LEs were given. Seventeen (2.1%) patients had severe withdrawal. Days of agitation, over-sedation, and delirium were minimal, with the median (IQR) of 0 (0-0). Few patients received adjunctive medications for symptom management. Intensive care unit (ICU) patients had more severe withdrawal than non-ICU patients, but received the same cumulative benzodiazepine dose | ||
| 520 | |a CONCLUSIONS: Most patients on the BAWS protocol received little-to-no benzodiazepines; severe withdrawal, agitation, delirium, or over-sedation were uncommon. This is the first evaluation of the BAWS protocol on a diverse population of hospitalized patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 7 | |a Hypnotics and Sedatives |2 NLM | |
| 650 | 7 | |a Benzodiazepines |2 NLM | |
| 650 | 7 | |a 12794-10-4 |2 NLM | |
| 650 | 7 | |a Lorazepam |2 NLM | |
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| 700 | 1 | |a Gilmore, Vi T |e verfasserin |4 aut | |
| 700 | 1 | |a Kruer, Rachel M |e verfasserin |4 aut | |
| 700 | 1 | |a Alvanzo, Anika Ah |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Edward S |e verfasserin |4 aut | |
| 700 | 1 | |a Murray, Paula |e verfasserin |4 aut | |
| 700 | 1 | |a Niessen, Timothy |e verfasserin |4 aut | |
| 700 | 1 | |a Perrin, Keisha |e verfasserin |4 aut | |
| 700 | 1 | |a Rastegar, Darius A |e verfasserin |4 aut | |
| 700 | 1 | |a Young, Samantha |e verfasserin |4 aut | |
| 700 | 1 | |a Jarrell, Andrew S |e verfasserin |4 aut | |
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