酒精戒断综合征患者中 mMINDS 与 CIWA-Ar 评分工具的相关性。

Correlation Between mMINDS and CIWA-Ar Scoring Tools in Patients With Alcohol Withdrawal Syndrome.

机构信息

Audrey J. Littlefield is clinical pharmacy manager, cardiothoracic intensive care unit, Department of Pharmacy, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York. Mojdeh S. Heavner is assistant professor of critical care, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, Maryland. Claire C. Eng is clinical pharmacy specialist, critical care, Department of Pharmacy, Memorial Hermann Katy Hospital, Katy, Texas. Dawn A. Cooper is service line educator and Jeanette M. Kurtz is assistant patient service manager, medical intensive care unit and step-down unit, Department of Nursing, Yale New Haven Hospital, New Haven, Connecticut. Jason J. Heavner is chair, Section of Critical Care, University of Maryland Baltimore Washington Medical Center, Glen Burnie, Maryland. Margaret A. Pisani is associate professor and director of the Pulmonary and Critical Care Fellowship Program, Yale University School of Medicine, New Haven, Connecticut.

出版信息

Am J Crit Care. 2018 Jul;27(4):280-286. doi: 10.4037/ajcc2018547.

DOI:10.4037/ajcc2018547

PMID:29961663

Abstract

BACKGROUND

Many alcohol withdrawal scoring tools are used in hospitalized patients to assess the severity of alcohol withdrawal and guide treatment. The revised Clinical Institute Withdrawal Assessment (CIWA-Ar) and the modified Minnesota Detoxification Scale (mMINDS) are commonly used but have never been correlated.

OBJECTIVE

To determine the strength of correlation between the CIWA-Ar and mMINDS scoring tools in patients with alcohol withdrawal syndrome.

METHODS

A single-center, prospective correlation study conducted at a large academic medical center. Patients treated for alcohol withdrawal syndrome according to the Yale Alcohol Withdrawal Protocol were identified daily, and both the CIWA-Ar and mMINDS were administered at each time point required by the protocol. Clinical data were obtained from the electronic medical records.

RESULTS

A total of 185 CIWA-Ar and mMINDS scores were collected in 30 patients. The Pearson correlation coefficient across all scores was 0.82, indicating a strong correlation. The Pearson correlation coefficient was 0.87 for CIWA-Ar scores of 10 or less and 0.52 for CIWA-Ar scores above 10. Strong correlations were also shown for tremor (0.98), agitation (0.84), and orientation (0.87).

CONCLUSIONS

The correlation between the CIWA-Ar and mMINDS tools is strong and appears to be most robust in patients with CIWA-Ar scores of 10 or less.

摘要

背景

许多酒精戒断评分工具被用于住院患者，以评估酒精戒断的严重程度并指导治疗。修订后的临床戒断评估量表（CIWA-Ar）和改良的明尼苏达州戒毒量表（mMINDS）是常用的工具，但两者从未进行过相关性分析。

目的

确定酒精戒断综合征患者中 CIWA-Ar 和 mMINDS 评分工具之间的相关性强度。

方法

在一家大型学术医疗中心进行的单中心前瞻性相关性研究。根据耶鲁酒精戒断方案治疗的酒精戒断综合征患者每天进行识别，并在协议要求的每个时间点进行 CIWA-Ar 和 mMINDS 评估。临床数据从电子病历中获取。

结果

共收集了 30 名患者的 185 个 CIWA-Ar 和 mMINDS 评分。所有评分之间的皮尔逊相关系数为 0.82，表明相关性很强。CIWA-Ar 评分为 10 或以下的患者的皮尔逊相关系数为 0.87，CIWA-Ar 评分为 10 以上的患者的皮尔逊相关系数为 0.52。震颤（0.98）、激越（0.84）和定向力（0.87）也显示出很强的相关性。