A STUDY OF RISK FACTORS OF DELIRIUM TREMENS IN PERSONS WITH ALCOHOL USE DISORDER IN A TERTIARY CARE HOSPITAL.

Abstract

Introduction: Delirium tremens is the severe form of alcohol withdrawal state that carries a certain degree of mortality. It is important to understand various risk factors associated with delirium tremens and compare with persons in alcohol withdrawal without delirium tremens. Objectives of the Study is to identify various risk factors associated with delirium tremens and to compare and identify any differences in risk factors for withdrawal syndrome in persons with alcohol use disorder with and without delirium tremens. This cross-sectional study Methodology: was conducted in the Department of Psychiatry at Hamdard Institute of Medical Science and HAHC Hospital, New Delhi on the patients with alcohol use disorder in withdrawal attending Department of Psychiatry, during period from January 2022 to June 2022. 75 patients with alcohol use disorder were taken. They were further categorised into 3 groups of patients which included patients with alcohol use disorder experiencing uncomplicated withdrawal, complicated withdrawal with or without delirium tremens. Patients with age range 18-60 years of either sex with illness of at least 12 months were taken. Severity of withdrawal was assessed by CIWA-Ar (Clinical Institute for Withdrawal of Alcohol scale containing ten items). Data was analysed using computer-based software (SPSS v16). Mean scores were calculated for both study populations for all the scales applied. Chi square test was used to make in between group comparisons for categorical variables with P value less than 0.05 was considered statistically signicant at 95 % condence level. Among the 75 patients Results: admitted for detoxication treatment during the period of January 2022- June 2023; 9 of the participants were suffering from uncomplicated withdrawal, 13 participants were suffering from complicated withdrawal without delirium tremens and 53 participants was suffering from complicated withdrawal with delirium tremens The factors signicantly associated with delirium tremens were previous history of DT (p=0.004**), binge drinking pattern (p=0.000**), history of morning alcohol consumption (p=0.000*), and delay in hospitalization (p=0.004**), and increased CIWA- AR score (p=0.001**). Patient admitted Conclusion: for detoxication should be carefully evaluated for these risk factors; and the vulnerable subjects with the presence of these risk factors should be cautiously managed and carefully monitored by the nurses taking care of these patients to prevent the occurrence of the fatal complication associated with alcohol withdrawal syndrome. Environmental manipulation, close observation and monitoring of vital signs, front loading dose of benzodiazepines are essential for preventing the occurrence of Delirium tremens during detoxication period.