ArticleMayo Clinic proceedings. Innovations, quality & outcomes2022
Benzodiazepine Treatment and Hospital Course of Medical Inpatients With Alcohol Withdrawal Syndrome in the Veterans Health Administration.
Article in Mayo Clinic proceedings. Innovations, quality & outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- Appropriateness, feasibility, and adoption of a nurse-driven CIWA-Ar symptom-triggered protocol for alcohol withdrawal syndrome in New York City public hospitals.American journal of medicine open · 2026Article
- Pharmacological Interventions for Alcohol Withdrawal Syndrome Among Hospitalized Adults: A Multicenter Cohort Study.Journal of general internal medicine · 2026Article
- Hospital-Wide Implementation, Clinical Outcomes, and Safety of Phenobarbital for Alcohol Withdrawal.JAMA network open · 2025Article
- [Analysis of the misdiagnosis causes and treatment strategies for burns combined with alcohol withdrawal syndrome].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2025Observational
- Guideline concordance of electronic health record order sets for hospital-based treatment of alcohol withdrawal syndrome.Journal of hospital medicine · 2025Article
- Prevention of alcohol withdrawal syndrome in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee Clinical Consensus Document.Trauma surgery & acute care open · 2022Article
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo describe initial benzodiazepine dosing strategies and factors associated with variation in benzodiazepine dosing in a national cohort of hospitalized patients with alcohol withdrawal syndrome (AWS). PATIENTS AND
methodsThis cross-sectional study included adult patients with AWS admitted to medical services and treated with benzodiazepines at 93 Veterans Health Administration hospitals in 2013. Treatment was categorized by initial benzodiazepine dosing strategy-fixed-dose, symptom-triggered, or front-loading. Associations with patient characteristics, facility, and cumulative benzodiazepine exposure, intensive care, and intubation were evaluated.
resultsAmong 6938 medical inpatients with AWS, 2909 (41.9%), 2829 (40.8%), and 1200 (17.3%) received treatment with symptom-triggered, fixed-dose, and front-loading benzodiazepines, respectively. The magnitude of differences in initial treatment associated with patient characteristics was small compared with differences associated with the predominant practice at a facility. Compared with fixed-dose therapy, symptom-triggered therapy was associated with higher cumulative benzodiazepine exposure (mean, 208-mg vs 182-mg diazepam equivalents) and higher probability of intensive care and intubation (28.2% vs 21.3% and 4.8% vs 3.5%, respectively).
conclusionThis study revealed that real-world AWS treatment of medical inpatients was often inconsistent with published guidelines recommending symptom-triggered long-acting benzodiazepines for AWS. The facility where a patient was hospitalized was associated with marked treatment variation. In contrast to prior randomized controlled trials conducted in specialized detoxification units, hospitalized patients who received symptom-triggered therapy in this study had greater cumulative benzodiazepine exposure and higher probability of intensive care and intubation than those receiving fixed-dose therapy.
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