ASAM Pocket Guidelines and Patient Guide

Alcohol Withdrawal Management

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43 Appropriate setting Summary of Evidence Reference Any Results of a study in 7 countries indicate that the ASSIST provides a valid measure of risk for individual substances and for total substance involvement. WHO, 2002 Any AUDIT is a useful alcohol screen in general medical settings and that its ability to correctly predict which patients will experience alcohol withdrawal is increased when used in combination with biological markers. Dolman et al., 2005; Saunders et al., 1993 Hospital Admission AUDIT-PC score is an excellent discriminator of AWS (Sensitivity=91%, Specificity =98.7%). Pecoraro et al., 2014 Hospital AWS scale had good performance in predicting alcohol withdrawal delirium. Wetterling et al., 1997a Hospital Patients demonstrated shorter overall course of alcohol withdrawal using the AWS compared with WAS. Foy et al., 2006 Hospital BAWS patients received less diazepiam and had fewer assessments, but both groups had similar lengths of stay, treatment completion rate, no incidence of seizure or delirium. Rastegar et al., 2017 ICU Excellent reliability and validity in identifying patients with delirium in ICU. Ely et al., 2001 Any Well established reliability and validity. Sullivan et al., 1989 Hospital Good reliability and validity specific to detection of delirium. Otter et al., 2005 Hospital GMAWS score of ≥1 predicted CIWA-A ≥8, with a sensitivity of 100% and a specificity of 12%. GMAWS score of ≥2 predicted CIWA-A ≥8, with a sensitivity of 98% and a specificity of 39%. Holzman et al., 2016b

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