Prediction_of_Alcohol_Withdrawal_Severity_Scale v.1

Have you ever undergone alcohol rehabilitation treatment (i.e., inpatient or outpatient treatment programs, or Alcoholics Anonymous attendance)?

Have you combined alcohol with any other substance of abuse during the last 90 days?

Evidence of increased autonomic activity (i.e., HR >120, tremor, sweating, agitation, nausea)

Have you ever experienced previous episodes of alcohol withdrawal?

Patient consumed any amount of alcohol within the last 30 days OR patient had a positive blood alcohol level (>200 mg/dL) upon admission

Intoxicated or drunk within the last 30 days?

Have you ever experienced withdrawal seizures?

Have you ever experienced delirium tremens (DTs)?

Have you combined alcohol with other “downers” (e.g. benzodiazepines, barbiturates) during the last 90 days?

Have you ever experienced blackouts?

Blood alcohol level (BAL) >200 mg/dL on presentation

Prediction of Alcohol Withdrawal Severity Scale screens hospitalized patients for complicated alcohol withdrawal (seizures, delirium tremens).

Jack Msonkho

models@cambiocds.com

@Cambio CDS

Why Use: Prevalence of at-risk or heavy alcohol use tends to be higher among adults actively seeking healthcare in the general population. Most patients undergoing alcohol withdrawal experience uncomplicated AWS and only need supportive care, but up to 20% have complicated AWS (i.e., withdrawal hallucinosis, seizures, delirium tremens), which can result in substantial morbidity and up to 15% mortality if unrecognized. With aggressive prevention and recognition, mortality rates decrease to 1-4% (Schuckit 2014). PAWSS Scores ≥4 were 93.1% sensitive and 99.5% specific for development of complicated AWS in prospective validation (Maldonado 2015). Formula for Evaluation: Each question has a yes or no answer and each no anser has a zero score, while selecting yes adds a one to the total score. The evaluation will be made based on the total score. A total score of less than 4 evaluates to Average While a total score of more than 3 evaluates to a High

Use in patients ≥18 years old admitted to general floor, with or without history of alcohol abuse.

Do not use in patients with active or uncontrolled seizure disorder.

Maldonado JR, Sher Y, Ashouri JF, et al. The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome. Alcohol. 2014;48(4):375-90. Validation Maldonado JR, Sher Y, Das S, et al. Prospective Validation Study of the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) in Medically Ill Inpatients: A New Scale for the Prediction of Complicated Alcohol Withdrawal Syndrome. Alcohol Alcohol. 2015;50(5):509-18.

OBSERVATION.prediction_of_alcohol_withdrawal_severity_scale.v0, EVALUATION.prediction_of_alcohol_withdrawal_severity_scale.v0

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