ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1569499
Alcohol Withdrawal in Patients with Liver Disease
Provisionally accepted
- 1Mayo Clinic Arizona, Scottsdale, United States
- 2Mayo Clinic, Rochester, Minnesota, United States
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Objective: This study investigated and compared the clinical characteristics and treatment outcomes of alcohol withdrawal syndrome (AWS) in patients with and without liver diseases.We conducted a retrospective chart review of all hospital admissions that received the CIWA-Ar protocol at the Mayo Clinic Health System between June 2019 and June 2022.In this retrospective cohort study, we analyzed data for 1,586 hospitalizations for 811 liver disease [LIV(+)] patients and compared the results with 14,604 hospitalizations for 9,281 patients without liver disease [LIV(-)].Compared to the LIV(-) group, LIV(+) patients had more alcohol use disorder (94.3% vs. 58%, P = 0.003), longer hospital length of stay [Median (25 th , 75 th percentiles): 93 (51,173) vs. 69 (43,125) hours, P = 0.001], longer time to reach peak CIWA-Ar scores [Mean ±SD: 26.3±35.9 vs. 2.4±32.5 hours, P = 0.001], lower first 24 hours lorazepam dose equivalents [3.5 (1.5, 7) vs. 3.5 (1.5, 8) mg, P = 0.001], and higher mortality rates (16.8% vs. 5.8%, P = 0.001). Within the LIV (+) cohort, no sex difference was depicted except for longer time to reach peak CIWA in males (Mean ±SD: 28.5±40.3 vs. 21.7±24.5 hours, P = 0.014).Conclusions: Our study highlights the higher mortality, hospital LOS, and ICU admissions in patients with liver cirrhosis and hepatic failure. We also recommend further controlled studies to examine the severity of AWS in hepatic patients, using other tools besides CIWA-Ar.
Keywords: Alcohol withdrawal, sex difference, Liver disease, CIWA-Ar, Alcohol use disoder
Received: 31 Jan 2025; Accepted: 29 Apr 2025.
Copyright: © 2025 Isazade, Hatem, Sharma, Zhang, Schneekloth and Abulseoud. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Osama Abulseoud, Mayo Clinic Arizona, Scottsdale, United States
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