Prevalence and Correlates of delirium tremens in Alcohol dependence syndrome at tertiary hospital

Background: The prevalence of  Delirium tremens (DT) is around 5-12%. Very few studies have looked into the prevalence of DT in general population and has shown varying results. The study aims at finding the prevalence of delirium tremens among alcohol dependents (AD) and a comparison of profiles of alcohol withdrawal syndrome (AWS) with DT and AWS without DT.

Method: A cross-sectional descriptive and matched control study was conducted in patients diagnosed as Alcohol dependent syndrome and admitted in Psychiatry in-patient ward for detoxification. Socio demographic and clinical variables  were assessed and compared between alcohol dependents who developed DT and  who did not developed DT.

Results: 24% of the patients with AD had/developed delirium tremens. The multivariate regression analysis model shows  variables like  Age>50years (AOR= 75.7,95% C.I=7.8-730), Caste( Janjati: AOR=4.2, 95% C.I=1.329-13.23,) and unemployment(AOR=54.2, 95%C.I=3.8-765.254),longer length(years) of alcohol consumption >20 years(AOR= 305,95%CI=3.4-2711),presentation within 48-72 hrs  since the last intake of alcohol (AOR=923,95%CI=38-22333),absence of nicotine consumption(AOR=40,95%C.I.=1.66-967) were significantly associated with development of delirium tremens. Similarly, those with educational status of higher secondary and above (AOR=0.7, 95% C.I =0.73-1.43), past history of absence of DT (AOR=0.013, 95% C.I=0.0002-0.77), less frequent intake of alcohol <3 times/week (AOR=0.001,95%C.I=0.001-0.07) had less likely developed  DT. These significant variables were further  assessed for their ability to predict the occurrence of delirium tremens in  ROC and  area under the curve for age, duration since last alcohol  intake and years of intake of alcohol were respectively = 0.799, 0.843 and 0.765.

Conclusion: Three features findings (older Age, more years of intake of alcohol, more  hrs since last intake of alcohol) were more likely seen in delirium tremens patients.

Author(s): Paudyal S

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