Ramírez-Velasco DE, Sánchez-Hernández G

Language: Spanish
References: 17
Page: 26-31
PDF size: 165.51 Kb.

ABSTRACT

Background: In Mexico, the alcohol abuse is a growing public health concern. Several scores have been designed, such as the Clinical Institute of AWS Assessment (CIWA, its acronym in English), Cushman’s Score and Alcohol Withdrawal Syndrome Score (AWS, its acronym in English), to help identifying severe symptoms that require more intensive management and reveal when treatment should be discontinued.
Objective: Determine the diagnostic performance of Cushman score and AWS, in the assessment of severity of alcohol withdrawal syndrome.
Materials and methods: We analyzed 40 patients aged 18 to 70 years, hospitalized in the Internal Medicine department with the diagnosis of alcohol withdrawal syndrome. For statistical analysis sensitivity, specificity, positive and negative predictive value and likelihood ratios of each alternative score was determined. We performed the Kappa agreement test (Kappa index) between the scores and ROC curve analysis to compare the diagnostic accuracy of both alternative scores.
Results:Ability to identify alcohol withdrawal syndrome with severe CIWAar score was determined as follows: Cushman score, S: 12% (95% CI 0% to 24%) and E: 93% (95% CI 80% to 100%). On the other hand, the AWS test showed S: 96% (95% CI: 88.3% - 103%) and E: 66.7% (95% CI: 42.8% - 90.5%). An analysis of concordance kappa obtaining an index of 0.64 between tests of AWS and CIWA-ar and an index of 0.05 between Cushman and CIWA- Ar.
Conclusion: AWS test estimated at high cutoff values, showed a better diagnostic performance than Cushman score.

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