How do you evaluate and manage patients pre-operatively who are at risk for acute alcohol withdrawal?
How do you decide when it is safe to proceed with surgery?
Community PollStarted
For a patient at risk of alcohol withdrawal, what is your usual approach to timing nonemergent surgery?
2 physicians have voted
Join Mednetto vote and see how they answered.
2 Answers
Mednet MemberInvited Expert
Hospital Medicine · Johns Hopkins Hospital
Answered on
1) Screen for unhealthy alcohol use, then predict complicated withdrawal.
- Screen with a validated tool:
- Full AUDIT ≥8
- AUDIT-PC ≥4
- AUDIT-C: (≥4 in men, ≥3 in women)
- These screens are sensitive for identifying patients who go on to withdraw, but most screen-positive patients do not withdraw; A posit...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Hospital Medicine · University of Minnesota
Answered on · Updated on
The approach would depend on the preoperative setting, risk of severe alcohol withdrawal, which can be estimated using the PAWSS tool (Maldonado et al., PMID 24657098), and timing of surgery.
- If there are any signs of severe active withdrawal, such as DT, delay surgery (after assessing risk-benefit ...
Join for free or sign in to see the full answer