알코올 의존 환자에서 진전섬망과 금단증상의 연관성
The Relationship of Alcohol Withdrawal Delirium and Alcohol Withdrawal Symptoms in Patients with Alcohol Dependence
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective：This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. Methods：This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. Results：The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. Conclusion：Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.
Abstract
Objective：This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. Methods：This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. Results：The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. Conclusion：Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.
참고문헌 (19)
- Mayo-Smith MF, "Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal", JAMA, 278, pp.144~151 (1997)
- clinical psychiatry, "Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences", pp.Lippincott Williams & Wilkins, Sadock BJ
- Khan A, "Predictors of mortality in patients with delirium tremens", Acad Emerg Med, 15, pp.788~790 (2008)
- Cushman P Jr, "Delirium tremens. Update on an old disorder", Postgrad Med, 82, pp.117~122 (1987)
- Ferguson JA, "Risk factors for delirium tremens development", J Gen Intern Med, 11, pp.410~414 (1996)
- Monte R, "Risk factors for delirium tremens in patients with alcohol withdrawal syndrome in a hospital setting", Eur J Intern Med, 20, pp.690~694 (2009)
- Eyer F, "Risk assessment of moderate to severe alcohol withdrawal--predictors for seizures and delirium tremens in the course of withdrawal. Alcohol Alcohol", Alcohol Alcohol, 46, pp.427~433 (2011)
- Wetterling T, "Clinical predictors of alcohol withdrawal delirium", Alcohol Clin Exp Res, 18, pp.1100~1102 (1994)
- Schuckit MA, "The histories of withdrawal convulsions and delirium tremens in 1648 alcohol dependent subjects", Addiction, 90, pp.1335~1347 (1995)
- Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation", J Chronic Dis, 40, pp.373~383 (1987)
- The physician’s guide to helping patients with alcohol problem, "National Institute on Alcohol Abuse and Alcoholism", Government Printing Office, ~, pp.NIH publication no. 95-3769 (1995)
- Wetterling T, "A new rating scale for the assessment of the alcohol-withdrawal syndrome (AWS scale)", Alcohol Alcohol, 32, pp.753~760 (1997)
- Palmstierna T., "A model for predicting alcohol withdrawal delirium", Psychiatr Serv, 52, pp.820~823 (2001)
- Lee JH, "Clinical predictors for delirium tremens in alcohol dependence", J Gastroenterol Hepatol, 20, pp.1833~1837 (2005)
- 이명갑, "진전섬망 환자에 대한 임상적 고찰", 대한응급의학회지, 13(4), pp.424~427 (2002), 대한응급의학회
- Zhang Z, "Prediction of delirium in critically ill patients with elevated C-reactive protein", J Crit Care, 29, pp.88~92 (2014)
- 고강, "알코올 금단 섬망의 발생 및 경과에 영향을 미치는 위험 요인", 신경정신의학, 51(6), pp.430~438 (2012), 대한신경정신의학회
- Conigrave KM, "Traditional markers of excessive alcohol use", Addiction, 98(2), pp.31~43 (2003)
- Kasper DL, "Harrison’s Principles of Internal Medicine", pp.1813~1816 (2005), McGraw-Hill