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Psychiatry"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study investigated and compared the clinical characteristics and treatment outcomes of alcohol withdrawal syndrome (AWS) in patients with and without liver diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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<jats:sup>th<\/jats:sup>, 75<jats:sup>th<\/jats:sup> percentiles): 93 (51,173) vs. 69 (43,125) hours, P = 0.001], longer time to reach peak CIWA-Ar scores [Mean \u00b1 SD: 26.3 \u00b1 35.9 vs. 2.4 \u00b1 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 \u00b1 SD: 28.5 \u00b1 40.3 vs. 21.7 \u00b1 24.5 hours, P = 0.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1569499","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T15:00:41Z","timestamp":1748271641000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol withdrawal in patients with liver disease"],"prefix":"10.3389","volume":"16","author":[{"given":"Vugar","family":"Isazade","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asmaa","family":"Yehia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umesh M.","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Schneekloth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama A.","family":"Abulseoud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.15121","article-title":"A systematic review of relative risks for the relationship between chronic alcohol use and the occurrence of disease","volume":"47","author":"Levesque","year":"2023","journal-title":"Alcohol Clin Exp Res (Hoboken)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1159\/000507643","article-title":"Alcohol use and gastrointestinal diseases","volume":"36","author":"Seitz","year":"2020","journal-title":"Visceral Med"},{"volume-title":"Gastrointestinal Disorders Related to Alcohol and Other Drug Use, in Textbook of Addiction Treatment: International Perspectives","year":"2021","author":"Chen","key":"B3"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000208","article-title":"The epidemiology of cirrhosis in the United States: A population-based study","volume":"49","author":"Scaglione","year":"2015","journal-title":"J Clin Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.17235\/reed.2020.7242\/2020","article-title":"Alcoholic-related liver disease: pathogenesis, management and future therapeutic developments","volume":"112","author":"Argemi","year":"2020","journal-title":"Rev Esp Enferm Dig"},{"key":"B6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1038\/s41572-018-0014-7","article-title":"Alcoholic liver disease","volume":"4","author":"Seitz","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.01872.x","article-title":"Population drinking and liver cirrhosis mortality: is there a link in eastern Europe","volume":"102","author":"Ramstedt","year":"2007","journal-title":"Addiction"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/09595230500293845","article-title":"Mortality and population drinking: a review of the literature","volume":"24","author":"Norstrom","year":"2005","journal-title":"Drug Alcohol Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1776","article-title":"Associations between alcohol use and liver-related outcomes in a large national cohort of patients with cirrhosis","volume":"5","author":"Pearson","year":"2021","journal-title":"Hepatol Commun"},{"key":"B10","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/j.jhep.2016.06.018","article-title":"Heavy daily alcohol intake at the population level predicts the weight of alcohol in cirrhosis burden worldwide","volume":"65","author":"Stein","year":"2016","journal-title":"J Hepatol"},{"volume-title":"Federal Reserve Bank of St. Louis Examples","year":"2018","key":"B11"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/acer.2019.43.issue-3","article-title":"New estimates of the mean ethanol content of beer, wine, and spirits sold in the United States show a greater increase in per capita alcohol consumption than previous estimates","volume":"43","author":"Martinez","year":"2019","journal-title":"Alcoholism: Clin Exp Res"},{"volume-title":"Surveillance Report120 Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977\u20132021","year":"2023","author":"Slater","key":"B13"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/acer.2019.43.issue-7","article-title":"Is there a recent epidemic of women\u2019s drinking? 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