Clinical characteristics and health outcomes in patients with alcohol withdrawal syndrome: an observational study from Oman

Abstract

BACKGROUND: Globally, alcohol withdrawal syndrome (AWS) is considered a serious medical diagnosis associated with increasing morbidity and mortality. Little information has been reported on the scope of the problem in Oman. OBJECTIVES: Study clinical characteristics, management, quality of care, and health outcomes of patients managed for AWS. DESIGN: Retrospective medical record review. SETTINGS: University hospital. PATIENTS AND METHODS: The study included all patients with AWS admitted from 1 October 2019 to 30 September 2020. We collected demographic and clinical characteristics and did a univariate analysis of factors related to 90-day readmission. MAIN OUTCOME MEASURES: Length of hospital stay, 90-day readmission, referral rate to alcohol rehabilitation center. SAMPLE SIZE AND CHARACTERISTICS: 150 male patients with median (IQR) age of 39.5 (32-48) years. RESULTS: Most patients (70.7%, n=106) were smokers and 44 (29.3%) had a history of drug abuse. The average length of hospital stay was 2.3 (0.9-4.6) days. Approximately 9% of total hospital bed days were used to care for patients with AWS. Chronic liver disease (35.3%), diabetes mellitus (24.7%), and hypertension (24.0%) were common among AWS patients. The 90-day readmission rate (32.7%) was high, and there was low referral to alcohol rehabilitation (16.7%). Diabetes and epilepsy were associated with 90-day readmission. CONCLUSION: AWS is an important diagnosis that represents an important burden on acute medical services. Establishing a drug and alcohol service in our institution is an essential step to optimise care for patients with alcohol-related disorders. LIMITATIONS: Retrospective, so unable to collect data on manifestations of AWS such as delirium tremens, which is the most severe form of AWS. Also, the reason for the lack of referral to an outpatient alcohol rehabilitation program was not apparent.