Volume 21 Supplement 2
Management of acute alcohol withdrawal in the setting of a quick diagnostic unit integrated in an emergency department setting
© Bøhm et al; licensee BioMed Central Ltd. 2013
Published: 9 September 2013
Alcohol consumption can have adverse social, legal, occupational, psychological, and medical consequences. The prevalence of alcohol-use disorders is high in Emergency Departments. The novel establishment of a Quick Diagnostic Unit (QDU) in an ED setting has allowed expeditious and focused, medically supervised acute alcohol withdrawal. The purpose of the study was to describe the alcohol-use disorder clientele and treatment in this new setting.
Chart review of an 8 month period April to December 2012. Values were given as means ± SEM. Significance was evaluated using Student’s two-tailed t-test for unpaired observations or Fisher’s exact test as appropriate. The level of significance was established at p < 0.05.
A total of 91 patients were included in the study, 74 men and 17 women. The patients in total amounted to 2.6% of the discharged patients from the QDU. There was no age difference between men and women, i.e. 51.2 ± 1.5 years vs 50.6 ± 2.5 years (p>0.80). Length of stay was 1.8 ± 0.2 days for men vs 2.5 ± 0.6 days for women (p>0.2). In 19% of the cases men held jobs, whereas none of the women were employed (p < 0.0001).
Among patients who received chlordiazepoxide (RisolidR) for withdrawal symptoms the total dose was 405 ± 43 mg (n = 53) among men vs 494 ± 105 mg (n = 14) among women (p > 0.30). Thus 72% of the men vs 82% (p > 0.10) of the women were in need of chlordiazepoxide. There were no differences between men and women with regard to need for ICU care or emergent psychiatric referral (p > 0.20). Men left the QDU against medical advice to a greater extent than women, i.e. 22% vs 6% (p < 0.002).
Women with alcohol-use disorders appear to be more marginalized than men. Thus, they are employed to a lesser extent than men, and numerically they are treated more frequently and with a higher total dose of chlordiazepoxide. Men are more capable or prone than women to reject treatment. Further studies of the QDU setting would be beneficial.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.