Scientific Poster Session I - Students Research-in-Progress

Students Research in Progress
  Saturday, October 12, 2024
  11:30 AM–01:00 PM

Abstract

Introduction: Heavy alcohol consumption has been a major contributor to emergency department (ED) visits in recent years, and alcohol withdrawal syndrome (AWS) leads to about 500,000 hospital admissions annually. AWS occurs due to downregulation of inhibitory GABAergic receptors following sudden alcohol cessation, resulting in a hyperexcitable state which may result in severe clinical manifestations of delirium tremens, hallucinations, seizures, and death. The cornerstone for AWS treatment typically involves symptom-triggered benzodiazepines to mitigate withdrawal risks. However, benzodiazepines come with their own complications, prompting the exploration of alternative options such as phenobarbital. Recent studies have presented encouraging evidence regarding the use of phenobarbital as a treatment for AWS. Nebraska Medicine currently has phenobarbital AWS protocols for intensive care and acute care units, but not the ED.

Research Question or Hypothesis: The aim of this study was to elucidate the management of AWS in the ED utilizing phenobarbital, either alone or in combination with benzodiazepines, and evaluate its impact on ED readmission rates.

Study Design: Single-center, retrospective observational study.

Methods: A retrospective chart review was conducted to assess the safety and efficacy of phenobarbital use for AWS in the ED in the 2023 calendar year. Data were pulled from the electronic health record (EHR) for patients treated in the ED with phenobarbital and a documented ICD10 code for any alcohol related disorder for calendar year 2023 (N = 280 encounters). Data collected included Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar) score, phenobarbital and benzodiazepine doses and route, pertinent lab values and vitals, past medical history, discharge medications, and ED readmission within 7 days. The primary outcome assessed was ED readmission within 3 days, and key secondary outcomes include ED readmission within 3-7 days, length of stay, and safety parameters. Descriptive statistics will be utilized to evaluate collected data.

Results: In-progress.

Conclusion: In-progress.

Presenting Author

Catherine Christopherson PharmD Candidate
University of Nebraska Medical Center

Authors

Krysta Baack PharmD, BCPS
Nebraska Medicine

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Megan Ott PharmD
Nebraska Medical Center