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• W4313236029 abstract "Introduction: Alcohol use is a major risk factor for traumatic injury and up to 30% of trauma patients experience alcohol withdrawal syndrome (AWS) during their hospital admission. Among trauma patients, the development of AWS is associated with worse outcomes. While benzodiazepines and phenobarbital are the mainstay of therapy to manage AWS, there is limited data on treatment for the prevention of AWS. The purpose of this study is to evaluate the safety and efficacy of phenobarbital for the prevention of AWS in this population. Methods: Adult patients admitted to the trauma service at an academic level 1 trauma center who received at least one dose of phenobarbital for the prevention of AWS between January 2019 and August 2021 were eligible for inclusion. Patients were case-matched to a control group managed with symptom-triggered therapy based on risk of developing AWS. Risk factors included: gender, age, history of AWS/delirium tremens (DT) or prior withdrawal seizures, selected lab values, and screening questionnaires. The primary endpoint was the need for rescue therapy for AWS. Secondary endpoints included the time to rescue therapy, ICU length of stay (LOS), and hospital LOS. Results: Overall, 110 patients were included in the study with 55 patients in each group. Patients in the phenobarbital group had higher baseline injury severity scores (p=0.03) and were more likely to be admitted to the ICU (44% vs 24%; p=0.03). The phenobarbital group required significantly less rescue therapy for AWS (16% vs 62%; p< 0.001) with a longer time to rescue therapy administration (26 vs 11 hours; p=0.01). The phenobarbital group had a longer hospital LOS (216 vs 87 hours; p=0.0001) but no difference in ICU LOS (80 vs 61 hours; p=0.36). There was no incidence of DT or seizures and no difference in intubation rates (7.3% vs 3.7%; p=0.68) between the groups. There was no incidence of hypotension associated with phenobarbital treatment. The most frequent phenobarbital dosing strategy was twice a day with an average duration of 88 hours. Conclusions: Patients managed with phenobarbital had a significantly lower need for rescue therapy for AWS with no increased incidence of adverse effects. Further studies should evaluate a protocolized treatment plan which may avoid alcohol withdrawal complications in this population." @default.
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• W4313236029 date "2022-12-15" @default.
• W4313236029 modified "2023-10-01" @default.
• W4313236029 title "1288: EVALUATION OF PHENOBARBITAL FOR PREVENTION OF ALCOHOL WITHDRAWAL IN TRAUMA PATIENTS" @default.
• W4313236029 doi "https://doi.org/10.1097/01.ccm.0000910888.02046.98" @default.
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