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The Clinical Institute Withdrawal Assessment (CIWA-A) for Patients in Alcohol Withdrawal

Description

The Clinical Institute Withdrawal Assessment (CIWA) score provides an accurate characterization of the severity of the alcohol withdrawal syndrome. It can be used to help determine the need for pharmacologic intervention with benzodiazepines or other medications.


 

Parameters used to calculate the score:

(1) nausea and vomiting

(2) tremor

(3) paroxysmal sweat

(4) anxiety

(5) agitation

(6) tactile disturbances

(7) auditory disturbances

(8) visual disturbances

(9) headache, fullness in head

(10) orientation and clouding of sensorium

 

Reponses are from 0 (normal) to 7 (severe).

 

CIWA score =

= SUM(points for each of the 10 parameters)

 

Interpretation:

• minimum score: 0, which indicates the absence of alcohol withdrawal signs and symptoms

• maximum score: 67

• Scores of 15-20 imply the need to begin pharmacologic intervention, particularly if a significant blood level of alcohol is still present.

 


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