Addiction Research Group, Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged, H-6720, Hungary.
Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged, H-6720, Hungary.
Drug Alcohol Depend. 2021 Mar 1;220:108536. doi: 10.1016/j.drugalcdep.2021.108536. Epub 2021 Jan 19.
Although the Clinical Institute Withdrawal Assessment for Alcohol - Revised (CIWA-Ar) is a gold standard tool for the clinical evaluation of alcohol withdrawal syndrome (AWS), a systematic analysis using the total scores of the CIWA-Ar as a means of an objective follow-up of the course and treatment of AWS is missing. The aims of the present study were to systematically evaluate scientific data using the CIWA-Ar, to reveal whether the aggregated CIWA-Ar total scores follow the course of AWS and to compare benzodiazepine (BZD) and non-benzodiazepine (nBZD) therapies in AWS.
1054 findings were identified with the keyword "ciwa" from four databases (PubMed, ScienceDirect, Web of Science, Cochrane Registry). Articles using CIWA-Ar in patients treated with AWS were incorporated and two measurement intervals (cumulative mean data of day 1-3 and day 4-9) of the CIWA-Ar total scores were compared. Subgroup analysis based on pharmacotherapy regimen was conducted to compare the effectiveness of BZD and nBZD treatments.
The random effects analysis of 423 patients showed decreased CIWA-Ar scores between the two measurement intervals (BZD: d = -1.361; CI: -1.829 < δ < -0.893; nBZD: d = -0.858; CI: -1.073 < δ < -0.643). Sampling variances were calculated for the BZD (v = 0.215) and the nBZD (v = 0.106) groups, which indicated no significant group difference (z = -1.532).
Our findings support that the CIWA-Ar follows the course of AWS. Furthermore, nBZD therapy has a similar effectiveness compared to BZD treatment based on the CIWA-Ar total scores.
虽然临床戒断评估酒精修订版（CIWA-Ar）是评估酒精戒断综合征（AWS）的金标准工具，但缺乏使用 CIWA-Ar 总分作为 AWS 病程和治疗客观随访的系统分析。本研究的目的是使用 CIWA-Ar 系统地评估科学数据，揭示 CIWA-Ar 总分是否符合 AWS 病程，并比较 AWS 中苯二氮䓬类（BZD）和非苯二氮䓬类（nBZD）治疗。
通过四个数据库（PubMed、ScienceDirect、Web of Science、Cochrane 注册中心）的关键字“ciwa”确定了 1054 个发现。纳入使用 CIWA-Ar 治疗 AWS 患者的文章，并比较了 CIWA-Ar 总分的两个测量间隔（第 1-3 天和第 4-9 天的累积平均值）。根据药物治疗方案进行亚组分析，比较 BZD 和 nBZD 治疗的效果。
423 例患者的随机效应分析显示，两个测量间隔之间 CIWA-Ar 评分降低（BZD：d = -1.361；CI：-1.829 < δ < -0.893；nBZD：d = -0.858；CI：-1.073 < δ < -0.643）。计算了 BZD（v = 0.215）和 nBZD（v = 0.106）组的抽样方差，表明组间无显著差异（z = -1.532）。
我们的研究结果支持 CIWA-Ar 符合 AWS 病程。此外，基于 CIWA-Ar 总分，nBZD 治疗与 BZD 治疗具有相似的效果。
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