Multiple admissions for alcohol withdrawal

Objective: The objective was to identify risk factors for multiple admissions for alcohol withdrawal syndrome (AWS) in patients admitted to a general medicine service. Methods:: A retrospective study was performed examining records of patients admitted for AWS between January 1, 2006 and December 31, 2008 to an academic tertiary referral hospital. Patients with a single admission were compared to patients with multiple admissions with respect to demographic and clinical variables. Results:: Three hundred and twenty-two patients accounted for 788 admissions. Of the 322 patients, 142 (44%) had multiple admissions. Compared to patients with a single admission, patients with multiple admissions were more likely to have a high school education or less (p=0.0071), a higher Charlson comorbidity index score (p=0.0010), a positive urine drug screen for non-alcohol drug (p=0.0002), psychiatric comorbidity (p=0.0303) and a higher CIWA-Ar maximum total score (p<0.0001). Conclusion:: In patients with AWS, we identified demographic and clinical variables associated with multiple admissions to a general medicine service. Our results indicate areas for a targeted multidisciplinary and multispecialty approach at initial intervention, which is especially important given the high rates of recidivism in this patient population.