Acute Addiction Liaison Team, Glasgow Addiction Services, Legal House, 101 Gorbals Street, Glasgow, G5 9DW, UK.
QJM. 2012 Jul;105(7):649-56. doi: 10.1093/qjmed/hcs020. Epub 2012 Feb 10.
Guidelines exist for the management of alcohol withdrawal syndrome (AWS) but few have been assessed as to their suitability for general hospitals. The Glasgow Assessment and Management guideline for alcohol has been specifically developed for use in this context.
To determine if this alcohol assessment guideline aids the management of AWS in general hospitals.
The four components of the Glasgow Assessment and Management of Alcohol guideline were evaluated. This included the use of the Fast Alcohol Screening Test (FAST) to identify at risk patients, a risk stratification strategy to indicate fixed dose or symptom-triggered benzodiazepine treatment, the Glasgow Modified Alcohol Withdrawal Scale (GMAWS) for symptom-triggered treatment and a clear recommendation for vitamin prophylaxis of Wernicke's encephalopathy.
FAST scores were assessed along with the CAGE (cut down, annoyed, guilty and eye-opener) screening tool to ascertain if a single screening tool could identify hazardous and dependent drinking. The GMAWS and Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) were compared between two medical units. A staff survey of the two AWS tools was also carried out.
FAST was able to identify both probable hazardous and dependent drinking. The GMAWS was reliable and gauged both physical and cognitive aspects of AWS. Staff generally preferred the GMAWS-based treatment as opposed to CIWA-Ar management and welcomed the Guideline as a whole.
The Glasgow Guideline aids the management of patients with AWS in an acute hospital setting. It allows early identification of at risk patients and directs effective therapeutic intervention.
有针对酒精戒断综合征（AWS）管理的指南，但很少有被评估为适合综合医院使用的。格拉斯哥酒精评估和管理指南是专门为此背景下开发的。
确定该酒精评估指南是否有助于综合医院管理 AWS。
评估了格拉斯哥酒精评估和管理指南的四个组成部分。这包括使用快速酒精筛查测试（FAST）来识别高危患者，使用风险分层策略来指示固定剂量或症状触发的苯二氮䓬类药物治疗，使用格拉斯哥改良酒精戒断量表（GMAWS）进行症状触发治疗，以及明确推荐维生素预防 Wernicke 脑病。
评估 FAST 评分以及 CAGE（减少、烦恼、内疚和睁眼）筛查工具，以确定单一筛查工具是否可以识别危险和依赖饮酒。在两个医疗单位之间比较 GMAWS 和临床酒精戒断评估研究所（CIWA-Ar）。还对两种 AWS 工具进行了员工调查。
FAST 能够识别可能的危险和依赖饮酒。GMAWS 可靠，评估了 AWS 的身体和认知方面。工作人员普遍更喜欢基于 GMAWS 的治疗，而不是 CIWA-Ar 管理，并欢迎整个指南。
格拉斯哥指南有助于急性医院环境中 AWS 患者的管理。它可以早期识别高危患者，并指导有效的治疗干预。
