{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:08:42Z","timestamp":1787584122002,"version":"build-2736575974"},"reference-count":10,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2023,2,16]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify the rates and possible predictors of alcohol withdrawal syndrome (AWS) among adult trauma patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a retrospective review of all adult patients (18 years or older) included in the 2017 and 2018 American College of Surgeons Trauma Quality Program Participant User File (PUF). The main outcomes were rates and predictors of AWS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>1\u2009677\u2009351 adult patients were included in the analysis. AWS was reported in 11\u2009056 (0.7%). The rate increased to 0.9% in patients admitted for more than 2\u2009days and 1.1% in those admitted for more than 3\u2009days. Patients with AWS were more likely to be male (82.7% vs. 60.7%, p&lt;0.001), have a history of alcohol use disorder (AUD) (70.3% vs. 5.6%, p&lt;0.001) and have a positive blood alcohol concentration (BAC) on admission (68.2% vs. 28.6%, p&lt;0.001). In a multivariable logistic regression, history of AUD (OR 12.9, 95%\u2009CI 12.1 to 13.7), cirrhosis (OR 2.1, 95%\u2009CI 1.9 to 2.3), positive toxicology screen for barbiturates (OR 2.1, 95%\u2009CI 1.6 to 2.7), tricyclic antidepressants (OR 2.2, 95%\u2009CI 1.5 to 3.1) or alcohol (OR 2.5, 95%\u2009CI 2.4 to 2.7), and Abbreviated Injury Scale head score of \u22653 (OR 1.7, 95%\u2009CI 1.6 to 1.8) were the strongest predictors for AWS. Conversely, only 2.7% of patients with a positive BAC on admission, 7.6% with a history of AUD and 4.9% with cirrhosis developed AWS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>AWS after trauma was an uncommon occurrence in the patients in the PUF, even in higher-risk patient populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>IV: retrospective study with more than one negative criterion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2022-001047","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T06:25:26Z","timestamp":1678947926000},"page":"e001047","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File"],"prefix":"10.1136","volume":"8","author":[{"given":"Tyler J","family":"Jones","sequence":"first","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishwajit","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3773-8124","authenticated-orcid":false,"given":"Kevin M","family":"Schuster","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D","family":"Becher","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M","family":"Kodadek","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5660-5293","authenticated-orcid":false,"given":"Kimberly A","family":"Davis","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3853-5425","authenticated-orcid":false,"given":"Adrian A","family":"Maung","sequence":"additional","affiliation":[{"name":"Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"key":"2025082410233199000_8.1.e001047.1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1001\/jamapsychiatry.2015.0584","article-title":"Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III","volume":"72","author":"Grant","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"2025082410233199000_8.1.e001047.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2014.01.004"},{"key":"2025082410233199000_8.1.e001047.3","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1001\/jama.2018.10574","article-title":"Will this hospitalized patient develop severe alcohol withdrawal syndrome?","volume":"320","author":"Wood","year":"2018","journal-title":"JAMA"},{"key":"2025082410233199000_8.1.e001047.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1989.tb00737.x"},{"key":"2025082410233199000_8.1.e001047.5","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2018547"},{"key":"2025082410233199000_8.1.e001047.6","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/phar.2127","article-title":"Implementation of an ICU-specific alcohol withdrawal syndrome management protocol reduces the need for mechanical ventilation","volume":"38","author":"Heavner","year":"2018","journal-title":"Pharmacotherapy"},{"key":"2025082410233199000_8.1.e001047.7","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12529"},{"key":"2025082410233199000_8.1.e001047.8","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/TA.0000000000002501","article-title":"Alcohol-Related trauma reinjury prevention with hospital-based screening in adult populations: an eastern association for the surgery of trauma evidence-based systematic review","volume":"88","author":"Kodadek","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410233199000_8.1.e001047.9","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1097\/CCM.0000000000002371","article-title":"Occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens following traumatic injury","volume":"45","author":"Salottolo","year":"2017","journal-title":"Crit Care Med"},{"key":"2025082410233199000_8.1.e001047.10","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/1060028020949137","article-title":"Phenobarbital monotherapy for the management of alcohol withdrawal syndrome in surgical-trauma patients","volume":"55","author":"Ammar","year":"2021","journal-title":"Ann Pharmacother"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2022-001047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:23:46Z","timestamp":1756056226000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2022-001047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,3]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/tsaco-2022-001047"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2022-001047","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}