title: Development of a rating scale to predict the severity of alcohol withdrawal syndrome.
abstract: OBJECTIVE
  Various factors that may influence the severity of the alcohol withdrawal syndrome (AWS) have been identified. We tested the predictive value of these factors compiled in a newly developed scale, LARS (Luebeck alcohol withdrawal risk scale).
  
  
  METHODS
  A total of 100 individuals (81 males, 19 females, mean age: 47.6 +/- 9.9 years) consecutively transferred to inpatient detoxification were included in this prospective study. All fulfilled the ICD-10 criteria for alcohol dependence. The LARS was applied at the time of admission. The course of the AWS was assessed by AWS-scale at least every 4 h. The maximum AWS-score was taken as indicator of the severity of AWS.
  
  
  RESULTS
  The mean AWS-score(max) was 6.5 +/- 3.3. In all 20% of the patients developed a severe AWS (AWS-score(max) > or =10). The maximum score usually occurred within 36 h after the last drink. A short version, the LARS11, was developed by statistically grounded item reduction. The optimal cut-off of the LARS11 was calculated as 10. The positive predictive value for severe AWS was 76%, while the negative predictive value was 98.7%. The sensitivity and specificity were high (95 or 92.5%, respectively).
  
  
  CONCLUSIONS
  LARS11 assessed immediately before detoxification appears to provide a useful estimate of mild/moderate versus severe AWS, and is now ready to be validated in an independent sample.
authors.affiliation: Department of Psychiatry, Psychosomatics, Psychotherapy, JW Goethe University, Frankfurt, Germany. tilman.wetterling@vivantes.de
authors.forename: Tilman
authors.initials: T
authors.lastname: Wetterling
authors.forename: Bernhard
authors.initials: B
authors.lastname: Weber
authors.forename: Markus
authors.initials: M
authors.lastname: Depfenhart
authors.forename: Barbara
authors.initials: B
authors.lastname: Schneider
authors.forename: Klaus
authors.initials: K
authors.lastname: Junghanns
mesh_terms: D000437:Alcoholism / Q000534:rehabilitation*; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology*; D011795:Surveys and Questionnaires
chemical_list: D000431:Ethanol