Related Risk Factors and Predictors of Occurrence of Delirium Tremens in Patients with Alcohol Dependence Syndrome Underwent Inpatient Detoxification Programme at Tertiary Care Hospital, Kolenchery, Kerala, India

Introduction: Delirium tremens is the severe form of alcohol withdrawal state that carries a certain degree of mortality. It is important to understand the contributing factors for the development of this complicated withdrawal state.

Objectives of the Study: is to identify the related risk factors associated with the occurrence of delirium tremens and identify the risk factors predict the occurrence of delirium tremens.

Methodology: This analytical, cross sectional study was carried out to identify the related risk factors associated with the development of delirium tremens (DT) among patients admitted for detoxification treatment of Alcohol dependence syndrome that fulfills ICD-10 diagnostic criteria at MMM De-addiction and research centre, MOSC Medical College Hospital, Kolenchery, Ernakulam dist, Kerala, India.

Results: Among the 104 patients admitted for detoxification treatment during the period of January 2014- June 2014; twenty-three subjects developed delirium tremens among these, 6 subjects developed withdrawal seizures. The factors significantly associated with delirium tremens are increasing age (p=0.001**), previous history of DT (p=0.001**), binge drinking pattern (p=0.001**), increased amount of alcohol consumption (p=0.02*), and delay in hospitalization (p=0.001**), and increased ASI score (severity of addiction) (p=0.001**). The significant predictors of Delirium tremens are binge drinking, alcoholic liver disease, and increased severity of addiction; among these the significant positive predictor of delirium tremens is increased severity of addiction (OR=1.9 p=0.008*)

Conclusion: patient admitted for detoxification should be carefully evaluated for these risk factors; and the vulnerable subjects with the presence of these risk factors should be cautiously managed and carefully monitored by the nurses taking care of these patients to prevent the occurrence of the fatal complication associated with alcohol withdrawal syndrome. Environmental manipulation, close observation and monitoring of vital signs, front loading dose of benzodiazepines are essential for preventing the occurrence of Delirium tremens during detoxification period.