Thrombocytopenia in Patients Hospitalized for Alcohol Withdrawal Syndrome and Its Associations to Clinical Complications

Alcohol Alcohol. 2019 Jan 9;54(5):503-509. doi: 10.1093/alcalc/agz061.

Abstract

Background: The aim of this study was to assess the predictive value of thrombocytopenia (TP) in alcohol withdrawal syndrome (AWS) as a marker of evolution of non-complicated AWS (nAWS) to severe, complicated AWS (cAWS): delirium tremens (DTs) and withdrawal seizures (wS), and to broaden knowledge about differences between nAWS and cAWS groups in relation to severity of TP.

Methods: This study involved 300 people (236 males and 64 females), aged 19-65 years (M = 44.64, SD = 11.32), hospitalized in the detoxification ward with ICD-10 diagnosis of F10.3 (AWS) or F10.4 (DTs), divided into nAWS and cAWS groups, 150 cases each. AWS severity was measured by CIWA-Ar. Available clinical and laboratory data were analyzed.

Results: TP was found in 139 (46%) of all subjects (nAWS = 32, cAWS = 107). nAWS and cAWS did not differ according to age, gender, length and severity of the last binge. A relationship between the occurrence of TP and cAWS was found (P < 0.001). The lower was the number of PLT, the more AWS incidence was observed. In CIWA-Ar, TP subjects had at least moderate AWS (P < 0.001). nAWS had higher PLT values than cAWS cases (Mrang = 195.96 vs. 105.04, P < 0.001). The predictive value of TP in cAWS was confirmed.

Conclusions: The study demonstrates that patients with AWS and TP (in particular <119k/mL) are at higher risk of developing cAWS.

Keywords: alcohol withdrawal syndrome; delirium tremens; predictors; thrombocytopenia.

MeSH terms

  • Adult
  • Aged
  • Alcoholism / diagnosis*
  • Alcoholism / epidemiology*
  • Alcoholism / physiopathology
  • Female
  • Hospitalization / trends
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / epidemiology*
  • Substance Withdrawal Syndrome / physiopathology
  • Thrombocytopenia / diagnosis*
  • Thrombocytopenia / epidemiology*
  • Thrombocytopenia / physiopathology