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Risk Factors Delirium Tremens Developing in Intoxicated Trauma Patient

Purpose: To identify a trauma patient with a positive blood alcohol on admission who is at risk for developing delirium tremens based on the findings of Lukan et al.

Description

Lukan et al identified risk factors for a trauma patient developing delirium tremens (DTs). These can help identify patients who may benefit from more aggressive management. The authors are from the University of Louisville, Stanford University and McLaren Regional Medical Center (Flint, Michigan).


Patient selection for study: Trauma patients who developed delirium tremens were compared to patients with a "positive" blood alcohol who did not develop DTs. It is a little unclear reading the methods section if all of the patients who developed DTs had a positive blood alcohol on admission.

 

A blood alcohol concentration >= 200 mg/L (0.2 g/L or 43.4 mmol/L) was present in 60% of patients who developed DTs.

 

Risk factors for the development of delirium tremens in multivariate analysis:

(1) white race

(2) age > 40 years of age

(3) burn injury as mechanism of injury

(4) mechanism of injury not motor vehicle collision

 

where:

• Other mechanisms of injury included: assault, fall, gunshot, motorcycle accident, pedestrian, stab, and other. In Table 2 a fall had an odds ratio of 2.5 for DTs.

 

Observations:

(1) A person who is not clinically intoxicated at the time of admission can undergo delirium tremens. Many people who develop DTs maintain a positive blood alcohol level at all times.

(2) A prospective study might be interesting.


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Specialty

Objective

ICD-10