Risk factors for delirium tremens in trauma patients.
BACKGROUND
The development of delirium tremens (DT) is associated with significant morbidity and mortality. This study identifies characteristics in trauma patients that are predictive of DT.


METHODS
Data from 1,856 trauma patients who either developed DT (n = 105) or had a positive blood alcohol concentration but did not develop DT (n = 1,751) were collected from the trauma registry of a Level I trauma center. Odds ratios were used to measure the association between predictors and DT as an outcome and between DT and length of stay as an outcome.


RESULTS
Of seven significant (p < 0.05) predictors of DT, four were retained after stepwise logistic regression: age >40, white race, burn as a mechanism of injury and, as a negative predictor, motor vehicle collision as a mechanism of injury. The DT group stayed an average of 6.5 and 5.2 days longer in the hospital and the intensive care unit, respectively, than those in the control group.


CONCLUSIONS
It is possible to determine which intoxicated trauma patients are at increased risk for DT using the above predictors. Patients who develop DT have worse outcomes than those who do not. Whether routine DT prophylaxis would improve outcomes among those at increased risk for DT is unknown, but deserves further study.
Lukan
James K
JK
Department of Surgery, University of Louisville Hospital, Kentucky 40292, USA. jameslukan@hotmail.com
Reed
Donald N
DN
Looney
Stephen W
SW
Spain
David A
DA
Blondell
Richard D
RD
D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers