Palmstierna developed a model for predicting delirium during alchol withdrawal. The author is from Karolinska Institute in Stockholm.
Patient selection: alcohol withdrawal
Outcome: delirium
Parameters from stepwise multiple regression:
(1) current infectious disease (pneumonia, urinary tract infection, etc)
(2) heart rate in beats per minute on admission
(3) signs of autonomic nervous system overactivity (sweating, tremor, nausea, tachycardia) AND alcohol concentration > 1 g/L (100 mg/dL, 0.1%) in body fluid
(4) history of epileptic seizure
(5) history of delirium
Parameter
Finding
Points
current infection
no
0
yes
0.334
heart rate
<= 120
0
> 120 (tachycardia)
0.126
autonomic nervous system overactivity with elevated alcohol concentration
no
0
yes
0.129
history of seizure
no
0
yes
0.068
history of delirious episode
no
0
yes
0.060
where:
• The points are based on the regression coefficients.
• The constant was -0.025.
risk of delirium =
= SUM(points for all 5 parameters)
If none of the findings are present then the risk of delirium is very low if adequately treated.
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