急性护理环境中医学毒理学家戒酒管理的趋势:2016-2022年毒理学调查联盟(ToxIC)核心登记处的分析

IF 2.2 4区 医学 Q3 SUBSTANCE ABUSE
John D DelBianco, Kira J Galeano, Gillian A Beauchamp, Ryan M Surmaitis, Stephanie E Shara, Alison Sutter, Hope Kincaid, Joseph J Stirparo, Kathryn L Wheel, Alexandra M Amaducci
{"title":"急性护理环境中医学毒理学家戒酒管理的趋势:2016-2022年毒理学调查联盟(ToxIC)核心登记处的分析","authors":"John D DelBianco, Kira J Galeano, Gillian A Beauchamp, Ryan M Surmaitis, Stephanie E Shara, Alison Sutter, Hope Kincaid, Joseph J Stirparo, Kathryn L Wheel, Alexandra M Amaducci","doi":"10.1093/alcalc/agaf047","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Alcohol withdrawal syndrome (AWS) requires urgent treatment to prevent morbidity and mortality. In the acute care setting, medical toxicologists play a critical role in AWS management, including the use of gamma-aminobutyric acid agonists and adjunctive medications. We aim to introduce the addiction medicine community to this role by describing clinical presentation and treatment of patients with AWS in the Toxicology Investigators Consortium Core Registry.</p><p><strong>Methods: </strong>Medical toxicologists from participating sites enter demographic, exposure, clinical presentation, and treatment data on all patients they evaluate into the Core Registry. This was a secondary analysis of registry patients evaluated for AWS from 2016 to 2022. Data were coded in a spreadsheet and analyzed using descriptive statistics.</p><p><strong>Results: </strong>We included 1093 cases. Agitation and delirium/toxic psychosis were documented in 373 (34.1%) and 227 (20.8%) patients, respectively. Benzodiazepines were the most common gamma-aminobutyric acid agonist treatment (n = 539, 49.3%). There was an overall decrease in the use of benzodiazepines alone and increases in the use of phenobarbital, ketamine, and dexmedetomidine. Intubation was performed in 115 (10.5%) patients. Naltrexone, used for alcohol use disorder, was given in 88 (8.1%) cases. The absolute number of AWS cases increased during this period.</p><p><strong>Conclusions: </strong>Use of benzodiazepines alone to manage AWS decreased while phenobarbital, ketamine, and dexmedetomidine use increased. Many patients had severe withdrawal manifestations, and some received alcohol use disorder treatment, suggesting that medical toxicologists see more severe cases in the acute care setting and have an opportunity to address the underlying use disorder.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"60 5","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309239/pdf/","citationCount":"0","resultStr":"{\"title\":\"Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016-2022.\",\"authors\":\"John D DelBianco, Kira J Galeano, Gillian A Beauchamp, Ryan M Surmaitis, Stephanie E Shara, Alison Sutter, Hope Kincaid, Joseph J Stirparo, Kathryn L Wheel, Alexandra M Amaducci\",\"doi\":\"10.1093/alcalc/agaf047\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Alcohol withdrawal syndrome (AWS) requires urgent treatment to prevent morbidity and mortality. In the acute care setting, medical toxicologists play a critical role in AWS management, including the use of gamma-aminobutyric acid agonists and adjunctive medications. We aim to introduce the addiction medicine community to this role by describing clinical presentation and treatment of patients with AWS in the Toxicology Investigators Consortium Core Registry.</p><p><strong>Methods: </strong>Medical toxicologists from participating sites enter demographic, exposure, clinical presentation, and treatment data on all patients they evaluate into the Core Registry. This was a secondary analysis of registry patients evaluated for AWS from 2016 to 2022. Data were coded in a spreadsheet and analyzed using descriptive statistics.</p><p><strong>Results: </strong>We included 1093 cases. Agitation and delirium/toxic psychosis were documented in 373 (34.1%) and 227 (20.8%) patients, respectively. Benzodiazepines were the most common gamma-aminobutyric acid agonist treatment (n = 539, 49.3%). There was an overall decrease in the use of benzodiazepines alone and increases in the use of phenobarbital, ketamine, and dexmedetomidine. Intubation was performed in 115 (10.5%) patients. Naltrexone, used for alcohol use disorder, was given in 88 (8.1%) cases. The absolute number of AWS cases increased during this period.</p><p><strong>Conclusions: </strong>Use of benzodiazepines alone to manage AWS decreased while phenobarbital, ketamine, and dexmedetomidine use increased. Many patients had severe withdrawal manifestations, and some received alcohol use disorder treatment, suggesting that medical toxicologists see more severe cases in the acute care setting and have an opportunity to address the underlying use disorder.</p>\",\"PeriodicalId\":7407,\"journal\":{\"name\":\"Alcohol and alcoholism\",\"volume\":\"60 5\",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309239/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alcohol and alcoholism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/alcalc/agaf047\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SUBSTANCE ABUSE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alcohol and alcoholism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/alcalc/agaf047","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
引用次数: 0

摘要

目的:酒精戒断综合征(AWS)需要紧急治疗,以防止发病率和死亡率。在急性护理环境中,医学毒理学家在AWS管理中发挥着关键作用,包括使用-氨基丁酸激动剂和辅助药物。我们的目标是通过描述毒理学调查协会核心注册中心中AWS患者的临床表现和治疗,向成瘾医学社区介绍这一角色。方法:来自参与站点的医学毒理学家将他们评估的所有患者的人口统计、暴露、临床表现和治疗数据输入Core Registry。这是对2016年至2022年接受AWS评估的注册患者的二次分析。数据在电子表格中编码,并使用描述性统计进行分析。结果:纳入1093例。躁动和谵妄/中毒性精神病分别有373例(34.1%)和227例(20.8%)。苯二氮卓类药物是最常见的γ -氨基丁酸激动剂(n = 539, 49.3%)。单独使用苯二氮卓类药物的总体减少,使用苯巴比妥、氯胺酮和右美托咪定的总体增加。115例(10.5%)患者行插管。88例(8.1%)患者使用纳曲酮治疗酒精使用障碍。在此期间,AWS病例的绝对数量有所增加。结论:单独使用苯二氮卓类药物治疗AWS减少,而苯巴比妥、氯胺酮和右美托咪定的使用增加。许多患者有严重的戒断症状,一些人接受了酒精使用障碍治疗,这表明医学毒理学家在急性护理环境中看到更多严重的病例,并有机会解决潜在的使用障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016-2022.

Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016-2022.

Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016-2022.

Aims: Alcohol withdrawal syndrome (AWS) requires urgent treatment to prevent morbidity and mortality. In the acute care setting, medical toxicologists play a critical role in AWS management, including the use of gamma-aminobutyric acid agonists and adjunctive medications. We aim to introduce the addiction medicine community to this role by describing clinical presentation and treatment of patients with AWS in the Toxicology Investigators Consortium Core Registry.

Methods: Medical toxicologists from participating sites enter demographic, exposure, clinical presentation, and treatment data on all patients they evaluate into the Core Registry. This was a secondary analysis of registry patients evaluated for AWS from 2016 to 2022. Data were coded in a spreadsheet and analyzed using descriptive statistics.

Results: We included 1093 cases. Agitation and delirium/toxic psychosis were documented in 373 (34.1%) and 227 (20.8%) patients, respectively. Benzodiazepines were the most common gamma-aminobutyric acid agonist treatment (n = 539, 49.3%). There was an overall decrease in the use of benzodiazepines alone and increases in the use of phenobarbital, ketamine, and dexmedetomidine. Intubation was performed in 115 (10.5%) patients. Naltrexone, used for alcohol use disorder, was given in 88 (8.1%) cases. The absolute number of AWS cases increased during this period.

Conclusions: Use of benzodiazepines alone to manage AWS decreased while phenobarbital, ketamine, and dexmedetomidine use increased. Many patients had severe withdrawal manifestations, and some received alcohol use disorder treatment, suggesting that medical toxicologists see more severe cases in the acute care setting and have an opportunity to address the underlying use disorder.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Alcohol and alcoholism
Alcohol and alcoholism 医学-药物滥用
CiteScore
4.70
自引率
3.60%
发文量
62
审稿时长
4-8 weeks
期刊介绍: About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信