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Development of an alcohol withdrawal risk stratification tool based on patients referred to an addiction liaison nursing service in Glasgow

Benson, George; McPherson, Andrew; McCallum, Jacqueline; Roberts, Nicola

Authors

George Benson

Andrew McPherson

Jacqueline McCallum



Abstract

Purpose
The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department.

Design/methodology/approach
A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population.

Findings
The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively.

Research limitations/implications
The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score.

Practical implications
The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life.

Originality/value
The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.

Citation

Benson, G., McPherson, A., McCallum, J., & Roberts, N. (2019). Development of an alcohol withdrawal risk stratification tool based on patients referred to an addiction liaison nursing service in Glasgow. Drugs and Alcohol Today, 19(4), 241-250. https://doi.org/10.1108/dat-02-2019-0009

Journal Article Type Article
Online Publication Date Jun 18, 2019
Publication Date Oct 23, 2019
Deposit Date Aug 30, 2022
Journal Drugs and Alcohol Today
Print ISSN 1745-9265
Electronic ISSN 2042-8359
Publisher Emerald
Peer Reviewed Peer Reviewed
Volume 19
Issue 4
Pages 241-250
DOI https://doi.org/10.1108/dat-02-2019-0009
Public URL http://researchrepository.napier.ac.uk/Output/2899198