RESUMEN
Alcohol dependence is a chronic disease whose treatment begins with detoxification, followed by rehabilitation. We present a descriptive and retrospective study of 147 patients admitted to our unit during the period 2003-2005. Median age was 46.07 years, with 77.6% men and 22.4% women. Admission diagnosis was alcohol withdrawal syndrome in 31 patients (21.1%) and programmed alcohol detoxification in 116 patients (78.9%). On the CIWA-Ar scale: mild withdrawal, 100 patients (68.5%), moderate, 35 patients (24%), severe, 11 patients (7.5%). Mild group showed a statistically significantly lower proportion of hepatopathy, by comparison with the moderate and severe groups. Statistically significant differences were found between the mild and severe groups on comparing mean age, duration of stay, quantity of alcohol and parameters of chronic consumption (ferritine, fe, VCM, UBE, AST, bilirubin and Mg) for AST and bilirubin. There were 11 seizures: 4 patients from the programmed group, with mild withdrawal on the CIWA-Ar scale, and 7 patients with moderate-severe withdrawal. No relationship was found between patients intensity of withdrawal syndrome, age or sex. There was higher intensity on the CIWA-Ar score (moderate and severe) among patients who had already begun withdrawal syndrome, compared to those admitted on a planned detoxification programme. The CIWA-Ar is a useful tool for assessing withdrawal symptoms and risks of complication and for planning treatment. Clinical practice must provide patients with access to health resources for the appropriate treatment of their addiction, with standardized assistance during their stay in hospital.
Asunto(s)
Alcoholismo/epidemiología , Alcoholismo/rehabilitación , Inactivación Metabólica , Medicina Interna/estadística & datos numéricos , Etanol/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Síndrome de Abstinencia a Sustancias/epidemiología , Síndrome de Abstinencia a Sustancias/etiologíaRESUMEN
La dependencia al alcohol es una enfermedad crónica y su tratamiento comienza con la desintoxicación, continuándose con la rehabilitación. Se presenta un estudio descriptivo y retrospectivo de las desintoxicaciones de alcohol en 147 pacientes ingresados en nuestra unidad en el periodo 2003-2005. La media de edad es de 46.07 años, 77.6% hombres y 22.4% mujeres. Ingreso por síndrome de deprivación alcohólica en 31 pacientes (21.1%), desintoxicación programada en 116 pacientes (78.9%). Según la escala CIWA-Ar: abstinencia grado leve 100 pacientes (68.5%), moderada35 (24%), grave 11 (7.5%). La estancia media global fue de 11.5 días, sin diferencias estadísticamente significativas. Grupo Leve con proporción significativamente menor de hepatopatía, grupos Moderado y Grave proporción significativamente alta. Al compararla media de la edad, estancia, cantidad de alcohol y parámetros de consumo crónico (ferritina, fe, VCM, UBE, GPT, GGT, bilirrubina y Mg), se encuentran diferencias significativas entre las medias de los grupos Leve y Grave para la GPT y bilirrubina total. Se produjeron crisis epilépticas en 11 pacientes, 4 pertenecían al grupo programado,7 con intensidad moderada-grave. No se ha evidenciado relación entre la intensidad del síndrome de deprivación, edad y sexo. Mayor intensidad en la escala CIWA-Ar (grados moderado y grave) entre los pacientes con síndrome de deprivación ya iniciado comparados con los ingresados programados, que predominantemente presentaban un grado leve. La CIWA-Ar es un instrumento útil para evaluar los síntomas de deprivación, el riesgo de complicaciones y planificar el tratamiento. La actitud clínica debe facilitar el acceso del paciente a los recursos sanitarios para el tratamiento de su adicción, normalizando la asistencia durante el ingreso hospitalario
Alcohol dependence is a chronic disease whose treatment begins with detoxification, followed by rehabilitation. We present a descriptive and retrospective study of 147 patients admitted to our unit during the period 2003-2005. Median age was 46.07 years, with 77.6% men and 22.4% women. Admission diagnosis was alcohol with drawal syndrome in 31 patients (21.1%) and programmed alcohol detoxification in 116 patients (78.9%). On the CIWA-Ar scale: mild withdrawal, 100 patients (68.5%), moderate, 35 patients (24%), severe, 11 patients (7.5%). Mild group showed a statistically significantly lower proportion of hepatopathy, by comparison with the moderate and severe groups. Statistically significant differences were found between the mild and severe groups on comparing mean age, duration of stay, quantity of alcohol and parameters of chronic consumption (ferritine, fe, VCM, UBE,AST, bilirubin and Mg) for AST and bilirubin. There were 11 seizures: 4 patients from the programmed group, with mild with drawal on the CIWA-Ar scale, and 7 patients with moderate-severe with drawal. No relationship was found between patients intensity of with drawal syndrome, age or sex. There was higher intensity on the CIWA-Ar score (moderate and severe) among patients who had already begun with drawal syndrome, compared to those admitted on a planned detoxification programme. The CIWA-Ar is a useful tool for assessing with drawal symptoms and risks of complication and for planning treatment. Clinical practice must provide patients with access to health resources for the appropriate treatment of their addiction, with standardized assistance during their stay in hospital