A National Analysis of Alcohol Withdrawal Syndrome in Patients with Operative Trauma

Jeffrey Balian; Nam Yong Cho; Amulya Vadlakonda; Joanna Curry; Nikhil Chervu; Konmal Ali; Peyman Benharash

Surgery Open Science (Jun 2024)

A National Analysis of Alcohol Withdrawal Syndrome in Patients with Operative Trauma

Jeffrey Balian,
Nam Yong Cho,
Amulya Vadlakonda,
Joanna Curry,
Nikhil Chervu,
Konmal Ali,
Peyman Benharash

Affiliations

Jeffrey Balian: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Nam Yong Cho: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Amulya Vadlakonda: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Joanna Curry: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Nikhil Chervu: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Konmal Ali: Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
Peyman Benharash: Corresponding author at: UCLA Division of Cardiac Surgery, 64-249 Center for Health Sciences, Los Angeles, CA 90095, USA.; Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

Journal volume & issue: Vol. 19
pp. 199 – 204

Abstract

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Background: Alcohol withdrawal syndrome (AWS) presents with a complex spectrum of clinical manifestations that complicate postoperative management. In trauma setting, subjective screening for AWS remains challenging due to the criticality of injury in these patients. We thus identified several patient characteristics and perioperative outcomes associated AWS development. Methods: The 2016–2020 National Inpatient Sample was queried to identify all non-elective adult (≥18 years) hospitalizations for blunt or penetrating trauma undergoing operative management with a diagnosis of AWS. Patients with traumatic brain injury or with a hospital duration of stay <2 days were excluded. Outcomes of interest included in-hospital mortality, perioperative complications, hospitalization costs, length of stay (LOS) and non-home discharge. Results: Of an estimated 2,965,079 operative trauma hospitalizations included for analysis, 36,415 (1.23 %) developed AWS following admission. The AWS cohort demonstrated increased odds of mortality (Adjusted Odds Ratio [AOR] 1.46, 95 % Confidence Interval [95 % CI] 1.23–1.73), along with infectious (AOR 1.73, 95 % CI 1.58–1.88), cardiac (AOR 1.24, 95 % CI 1.06–1.46), and respiratory (AOR 1.96, 95 % CI 1.81–2.11) complications. AWS was associated with prolonged LOS, (β: 3.3 days, 95 % CI: 3.0 to 3.5), greater cost (β: +$8900, 95 % CI $7900–9800) and incremental odds of nonhome discharge (AOR 1.43, 95 % CI 1.34–1.53). Furthermore, male sex, Medicaid insurance status, head injury and thoracic operation were linked with greater odds of development of AWS. Conclusion: In the present study, AWS development was associated with increased odds of in-hospital mortality, perioperative complications, and resource burden. The identification of patient and operative characteristics linked with AWS may improve screening protocols in trauma care.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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