title: [Comparison of Two Symptom-Triggered Treatments for Alcohol Withdrawal: HAES vs. SAB-P].
abstract: BACKGROUND
  For alcohol withdrawal during hospitalization, often a medication as means for withdrawal needs to be chosen. Modern, score-controlled processes that can be used by the nursing staff after instruction by physicians are frequently not used and even unknown in hospitals. One reason for this is that some of the scores require checking several criteria and are therefore more time-consuming and complicated than use of a fixed-dosage strategy. The SAB-P and HAES are short with only 6 items that can be checked by the nursing staff.
  
  
  METHODS
  Safety of the Hamburg Alcohol Withdrawal Scale (Hamburger Alkoholentzugs-Skala (HAES)) was analyzed retrospectively and prospectively with regard to score-controlled alcohol-withdrawal treatment after rating by the nurse staff (Scoregesteuerte Alkoholentzugsbehandlung nach Rating durch das Pflegepersonal (SAB-P)).
  
  
  RESULTS
  Incidence of complications in patients treated with SAB-P and HAES was nearly similar with 1% start of delirium and 3% seizures (SAB-P) and 0.5 to 1.5% start of delirium and 0 to 0.5% seizures in the HAES group. With both scales it was possible to start medical treatment while still under falling alcohol levels (0.93 and 0.91%, respectively). Medication dosage was initially higher using the HAES, so that the time needed to monitor withdrawal symptoms could be reduced (3.8 vs. 3.1 days).
  
  
  CONCLUSIONS
  Using a score-controlled strategy for alcohol withdrawal leads to a lower complication rate than found in literature. The structured procedure was helpful for the nursing staff as well as for the physicians. SAB-P as well as HAES made withdrawal for the patients more comfortable and led to fewer complaints. Because of rapid reaction and faster symptom reduction of HAES, there was less time necessary for monitoring. Simple handling, clomethiazol, oxazepam or diazepam as applicable medication and clear documentation are the advantages of HAES.
authors.affiliation: Zentrum für Interdisziplinäre Suchtforschung, UKE Hamburg.
authors.forename: R
authors.initials: R
authors.lastname: Holzbach
authors.affiliation: Dr. Becker Klinik Möhnesee, Möhnesee.
authors.forename: C
authors.initials: C
authors.lastname: Ihlow
authors.affiliation: LWL-Klinik Gütersloh.
authors.forename: T
authors.initials: T
authors.lastname: Takla
authors.affiliation: LWL-Klinik Gütersloh.
authors.forename: U
authors.initials: U
authors.lastname: Kemper
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, UKE Hamburg.
authors.forename: D
authors.initials: D
authors.lastname: Naber
mesh_terms: D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000453:epidemiology / Q000628:therapy; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D002492:Central Nervous System Depressants / Q000097:blood; D002719:Chlormethiazole / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D013375:Substance Withdrawal Syndrome / Q000150:complications / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D002719:Chlormethiazole; D000431:Ethanol; D003975:Diazepam