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Alcohol and Alcoholism Advance Access published online on September 16, 2006
Alcohol and Alcoholism, doi:10.1093/alcalc/agl068
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© The Author 2006. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved
Received March 7, 2006
Revised August 2, 2006
Accepted August 2, 2006

Article

DEVELOPMENT OF A RATING SCALE TO PREDICT THE SEVERITY OF ALCOHOL WITHDRAWAL SYNDROME

TILMAN WETTERLING 1 *, BERNHARD WEBER 1, MARKUS DEPFENHART 1, BARBARA SCHNEIDER 1, and KLAUS JUNGHANNS 2

1 Department of Psychiatry, Psychosomatics, and Psychotherapy, J. W. Goethe University, Frankfurt/M., Germany
2 Department of Psychiatry and Psychotherapy, University Medical School of Lübeck, Lübeck, Germany

* To whom correspondence should be addressed.
TILMAN WETTERLING, E-mail: tilman.wetterling{at}vivantes.de


  Abstract

Aim: Various factors that may influence the severity of the alcohol withdrawal syndrome (AWS) have been identified. We tested the predictive value of these factors compiled in a newly developed scale, LARS (Luebeck alcohol withdrawal risk scale). Method: A total of 100 individuals (81 males, 19 females, mean age: 47.6 ± 9.9 years) consecutively transferred to inpatient detoxification were included in this prospective study. All fulfilled the ICD-10 criteria for alcohol dependence. The LARS was applied at the time of admission. The course of the AWS was assessed by AWS-scale at least every 4 h. The maximum AWS-score was taken as indicator of the severity of AWS. Results: The mean AWS-scoremax was 6.5 ± 3.3. In all 20% of the patients developed a severe AWS (AWS-scoremax ≥10). The maximum score usually occurred within 36 h after the last drink. A short version, the LARS11, was developed by statistically grounded item reduction. The optimal cut-off of the LARS11 was calculated as 10. The positive predictive value for severe AWS was 76%, while the negative predictive value was 98.7%. The sensitivity and specificity were high (95 or 92.5%, respectively). Conclusion: LARS11 assessed immediately before detoxification appears to provide a useful estimate of mild/moderate versus severe AWS, and is now ready to be validated in an independent sample.


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