An observational study in Substance Withdrawal Syndrome, sponsored by University Hospital, Basel, Switzerland. Completed at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2016-07-12.
Sponsored by University Hospital, Basel, Switzerland · Observational
In ear, nose, throat (ENT) and jaw surgery departments, up to 60% of patients suffer from alcohol dependence (Allen et al., 2009), and may develop an alcohol withdrawal syndrome (AWS) when undergoing sur-gery. Caring for these patients creates a major challenge for all persons involved: Health care staff is not only challenged by the primary illness but also by increased risk of life-threatening complications (infection, bleeding, cardiopulmonary dysfunction, impaired wound healing, re-operation), higher mortality rate, and longer duration of hospitalization due to preoperative alcohol use and the development of an AWS (Delgado-Rodriguez, Gomez-Ortega, Mariscal-Ortiz, Palma-Perez, \& Sillero-Arenas, 2003; Eyer et al., 2011; Foy, Kay, \& Taylor, 1997; Genther \& Gourin, 2012; Kuo et al., 2008; Mayo-Smith et al., 2004; McCusker, Cole, Abrahamowicz, Primeau, \& Belzile, 2002; Neyman, Gourin, \& Terris, 2005; O'Brien et al., 2007). Moreover, nearly five percent of all patients with an AWS develop an alcohol withdrawal delirium (AWD) which, without any therapy, will end lethally in 15% of all cases. With adequate medical and other interventions lethality is about two percent (Diener, 2003; Wright, Myrick, Henderson, Peters, \& Malcolm, 2006). Additionally, the occurrence of an AWS and / or AWD represents a threatening, time-intensive and complex situation for family members (Repper-DeLisi et al., 2008; Yu et al., 2012).
Since 2011, in addition to patients undergoing short-term surgery, also patients with oncological diagnoses are hospitalized in the ENT and Jaw Surgery Department at the University Hospital Basel (USB). These patients are in need of prolonged surgical treatments and resulting longer periods of abstinence from food and drink, including alcohol and other substances, increase the risk of alcohol withdrawal. For instance, in the ENT and Jaw Surgery Department, in 2011, 74 out of 910 inpatients were at risk for or already experienced an AWD and 47 of them needed permanent supervision to guarantee their safety. Bridging the period of abstinence by drinking alcohol pre- and postoperatively is a suboptimal option for these patients due to the relatively long surgical treatment. This situation called for action: based on positive experiences within the dementia-delirium-programme of USB (Hasemann \& Pretto, 2006), an evidence-based approach to screen for, detect and treat AWS and / or AWD in ENT and jaw surgery patients was developed and implemented (Hasemann, 2013). Now, this new approach needs to be evaluated.
The aims of the proposed study are to describe patient trajectories and to evaluate the processes and structures of the nurse-led approach in the ENT and Jaw Surgery Department at USB. The following research questions were generated:
Aim 1): Who are the patients captured with the algorithm, what are their risk factors, and how are the patient trajectories in terms of decisions, development, start, duration and ending of AWS and / or AWD? Specific questions asked:
Aim 2): How is the prevention algorithm adhered to? Specific questions asked:
131 studies on the registry are indexed under Substance Withdrawal Syndrome; 8 are open to participants now.
This study's enrollment of 89 is below the median of 130 across 31 observational studies indexed under Substance Withdrawal Syndrome.
Browse Substance Withdrawal Syndrome studies →University Hospital, Basel, Switzerland is the lead sponsor of 989 studies on the registry; 189 are open to participants now.
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adult patient hospitalized with an ENT or jaw carcinoma
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Exclusion Criteria:
Adherence to screening and action algorithm
Nurses' and doctors' adherence to the patients' surveillance algorithm
Percentage of fulfilled steps of the algorithm
Time frame: baseline until hospital discharge; hospital stay will last 72 hours minimum over a retrospective period of two years
Percentage of patients developping alcohol withdrawal delirium under surveillance algorithm
Percentage of patients in the substitution programme developping withdrawal delirium
Time frame: baseline until hospital discharge over a retrospective period of two years; hospital stay will last 72 hours minimum
This study is completed, as verified in Jul 2016. You cannot join it, but the record below documents what was studied.
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Substance Withdrawal Syndrome →
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