Abstract
Introduction and Aim: Management strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively. Studying the pattern and predictors of alcohol withdrawal syndrome was the main objective of our study.
 
 Materials and Methods: A total of 100 consenting male patients in the age group of 18-60 years diagnosed with alcohol dependence and uncomplicated alcohol withdrawal undergoing in-patient detoxification in tertiary care center in north India were included in the study. A semi structured proforma was used to collect socio-demographic data, Alcohol Use Disorders Identification Test (AUDIT) was used as screening tool and Clinical Institute Withdrawal Assessmentfor Alcohol-revised (CIWA- Ar) was used to assess severity of withdrawal.
 
 Results: Symptoms like difficulty in orientation, seizures and hallucinations were relatively specific for severe AWS, while tremors and anxiety were common to all the patients and were non-specific for predicting severity of AWS. The severity of AWS symptoms correlated significantly with increasing age, duration of alcohol use and AUDIT score.
 
 Conclusion:We concluded that increasing age, longer duration of alcohol use, higher AUDIT score and symptoms related to hallucinations, orientation and seizure are linked to severe alcohol withdrawal. Prior knowledge of these predictors will help to identify the patients at risk of severe alcohol withdrawal so that individual care can be enhanced.
Highlights
Introduction and AimManagement strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively
Despite its historical relevance and wide prevalence, it was not until the late 1950s that it was definitively proved that the alcohol withdrawal syndrome (AWS) is a combination of varied physiological manifestations that occur on a continuum as a response to the sudden cessation or reduction of alcohol consumption [2]
We found that difficulty in orientation, seizures and hallucinations were relatively specific for severe AWS, while tremors and anxiety were common to all the patients and were non-specific for predicting severity of AWS
Summary
Introduction and AimManagement strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively. A combination of various clinical features in alcohol dependent individuals constitute the Alcohol Withdrawal Syndrome, known as AWS in short They appear 24-48 Hrs after cessation of alcohol intake or a reduction in its quantity [3]. Commonly only mild symptoms are seen, but in some cases where the individual is dependent on alcohol, its abrupt stoppage may lead to a severe autonomic dysfunction and encephalopathic state like ‘delirium tremens’ or even withdrawal seizures. Both these conditions may prove to be fatal [4]. These states occur along a timeline relative to time from the reduction in alcohol intake, but patients do not progress linearly from one stage to the often skipping one or more of them [5]
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