Risk Factors for Development of Delirium in Alcohol Use Disorder, A Case Control Study from A Tertiary Psychiatry Hospital in Kerala.

BACKGROUND: Alcohol withdrawal delirium is a medical emergency that can result in significant mortality and morbidity. Patients with delirium are a danger to themselves and others because of unpredictability of their behavior. So identification of risk factors for development of delirium is necessary for early treatment in patients with alcohol use disorder so that delirium can be prevented in such patients. AIM: To assess the risk factors for development of delirium tremens in alcohol use disorder. Methods: This is a case control study design. Sample consisted of male patients aged 18-64 years diagnosed as alcohol use disorder according to DSM5 .Sample size calculated as 33 cases and 66 control. Patients who developed delirium in withdrawal period were compared in terms of sociodemographic factors, historical parameters, treatment details and biochemical parameters with other patients who doesn’t developed delirium. RESULTS: Past history of DT was found to be one among the strongest predictive factor for occurrence of DT (P=0.006). Delirium tremens was more found among people who received low dose that is below 8mg of lorazepam. CIWA score which rates the severity of withdrawal symptoms, SADQ score which looks for severity of dependence found to be significant statistically with higher score predicting the occurrence of DT. Tachycardia at time of admission also found to be a significant clinical predictor. CONCLUSION: Main goal for alcohol withdrawal management should be prevention of emerging delirium by identifying these predictors. Each treatment should be individualized with detailed clinical history and evaluation to prevent the dreaded mortality and morbidity associated with DT.