Abstract
Introduction: Delirium tremens (DT) is the most severe complication of alcohol withdrawal and can be fatal if not recognized early. Identifying at-risk patients is challenging, especially in those presenting with seizures who are often too unwell to give a clear history.
Methods: We conducted a retrospective case-control study at the Department of Psychiatry, Lumbini Medical College and Teaching Hospital. We included 124 patients—62 cases who developed DT and 62 age- and sex-matched controls with uncomplicated withdrawal. Data on demographics, clinical history, laboratory parameters, and vital signs were extracted from medical records. Statistical analysis was performed using PSPP 2.1.1.
Results: A history of complicated withdrawal was strongly associated with DT (OR = 12.27, 95% CI: 2.72–55.35, p = 0.001). Patients with DT had significantly higher MCV (95.45 vs. 91.92 fL, p = 0.004), SGOT (200.61 vs. 102.50 U/L, p = 0.002), systolic BP (138.00 vs. 128.50 mmHg, p < 0.001), and diastolic BP (84.00 vs. 78.00 mmHg, p = 0.001). Platelet count (167,590.16 vs. 179,800.00 ×10³/μL, p = 0.01) and potassium (3.78 vs. 3.93 mEq/L, p = 0.049) were significantly lower among cases. No significant differences were observed for hemoglobin, bilirubin, SGPT, ALP, sodium, creatinine, urea, or pulse rate.
Conclusions: A history of complicated withdrawal, elevated MCV and SGOT, higher blood pressure, lower platelets, and lower potassium were significantly associated with DT. These readily available parameters can help clinicians identify high-risk patients early and initiate timely preventive measures.
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