Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome

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Of these, some develop alcohol withdrawal syndrome (AWS) of variable intensity when they stop drinking. There are numerous factors that likely influence this variability: genetic, epidemiological, clinical, sociodemographic, etc.<a class="elsevierStyleCrossRefs" href="#bib0015">3–6</a> Studies have indicated that the course of previous AWS episodes is the most reliable predictor of the progression of subsequent episodes.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> However, the involvement of other comorbidities is unclear, as are the clinical or analytical factors associated with the most severe forms.<a class="elsevierStyleCrossRefs" href="#bib0025">5,7</a> Moreover, the influence of sociodemographic factors on the long-term success of alcohol detoxification treatment has been assessed,<a class="elsevierStyleCrossRefs" href="#bib0025">5,8</a> but their influence on the clinical course of the AWS itself is unknown.The aim of this study is to analyze the influence of epidemiological and sociodemographic factors on the development of complicated AWS at hospital admission.Patients and methodsWe conducted a multicenter, observational, prospective registry of patients with AWS, hospitalized consecutively in 12 Spanish internal medicine departments, from January 1, 2013 to December 31, 2014. The diagnosis of AWS and delirium tremens (DT) was established according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision).<a class="elsevierStyleCrossRef" href="#bib0045">9</a> The study was approved by the ethics committees of all participating centers.We recorded sociodemographic, epidemiological, clinical and progression data in a database created for this purpose. We defined the pattern of regular alcohol abuse as the intake of constant daily quantities. The pattern of irregular alcohol abuse was defined as the intake of variable quantities, in peaks and valleys, over the course of days or weeks, for the 6 months prior to admission. Complicated alcohol withdrawal was defined as that which progressed with seizures or DT.Statistical analysisWe performed a descriptive study of the variables. To identify the predictors, we compared the means using Student's t-test and/or the Mann–Whitney U test after determining the normality and homogeneity of the variances. For the qualitative variables, we used the chi-squared test and Fisher's exact test when the cells contained values less than 5. We considered the level of statistical significance to be less than 0.05. We performed a logistic regression analysis to study the degree of association between the various factors and complicated AWS. We calculated the adjusted odds ratio values and their respective confidence intervals. The statistical analysis was conducted with the SPSS® 15 statistics software package.ResultsWe studied 228 episodes of hospitalization with AWS in 219 patients. The mean age was 54.4 years (SD, 11.5), and most of the participants (207, 90.8%) were men. AWS was the cause for hospitalization in 91 cases (39.9%), and 137 (60.1%) were hospitalized for other reasons but developed AWS during their stay. Seizures were recorded in 62 cases (27.1%), which were generalized in 53 (85.4%) cases, partial secondarily generalized in 7 (11.3%) cases and partial in 2 cases (3.2%). Seventy-four (32.4%) episodes progressed with DT. The mean Charlson index was 2 (SD, 1.8). Fifty-two (22.8%) patients were admitted to the intensive care unit, and the mean hospital stay was 15.6 days (SD, 27.8). The most common treatment regimen was fixed plus rescue dosage (71%), followed by fixed dosage (25%). Some 89.9% of the patients were treated with benzodiazepines, 42.9% with neuroleptics, 22.8% with clomethiazole and 14.4% with propofol. There were 5 deaths (2.1%).The daily alcohol intake was 173.3g (SD, 120.9) or 17.8 standard drink units (SD, 21.4), with a mean duration of alcohol consumption of 28.7 years (SD, 13.5) and of dependence of 16.6 years (SD, 11.3). Wine was the most common beverage in the patients who consumed a single type of alcohol, with 64 cases (28%), followed by beer with 33 (14.4%) cases and spirits with 18 (7.8%). Multiple consumption of alcoholic beverages was recorded in 111 patients (48.6%). Of these, the most common combination was wine and beer (29.7%), followed by wine, beer and spirits (25.2%). A total of 72 patients (31.5%) had undergone failed detoxification programs, and 71 (31.1%) patients had previously experienced AWS with hospitalization. During the 12 months prior to the index admission, hospital emergency department visits for alcohol consumption were recorded for 62 patients (27.1%). The pattern of alcohol abuse was documented in 219 cases, of which 189 were regular (82.8%) and 30 were irregular (13.1%). One hundred and fifty patients consumed tobacco (65.7%), 11 (4.8%) consumed cannabis, 12 (5.2%) consumed cocaine, 7 (3%) consumed opioids, and 3 (1.3%) consumed synthetic drugs.We recorded the marital status in 216 cases; of these, 83 (38.4%) were married or lived with a partner, 47 (20.4%) were separated, 78 (36.1%) were single, and 8 (3.4%) were widowers. Some 45.6% of the patients had children. At admission, 51 patients (22.3%) were employed, 81 (35.5%) were unemployed, and 85 were retired (37.2%). The marital status of 13 (5.7%) patients was unknown. The education level was determined in 194 patients: 23 (11.8%) had no formal education, 110 (56.7%) had primary education, 55 (28.3%) had secondary (high school diploma or equivalent or professional training), and 6 had university education (3.1%).We identified 110 episodes of complicated AWS. The epidemiological characteristics regarding alcohol consumption in this group compared with those of uncomplicated AWS (118 cases) are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The patients with complicated AWS had a tendency toward greater alcohol consumption (in terms of volume) and a higher number of previous hospitalizations for AWS and hospital emergency department visits. The concomitant consumption of cocaine and drug abuse other than alcohol (cannabis, opioids, synthetic drugs or cocaine) was associated with a greater risk of complicated AWS, as was hospitalization prompted by AWS. There were no differences in terms of the type of alcoholic beverage, the years of dependence or the pattern of intake.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The demographic characteristics of both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. The patients with complicated AWS were younger, but there were no differences in terms of sex, size of the hospital of origin or the patients’ population setting. We also observed no associations with marital status or employment status. However, the patients with a lower education level (illiterate or primary studies) had a greater chance of presenting seizures or DT.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The multivariate analysis included the variables age, sex, education level, employment status, marital status, years of consumption, grams of alcohol consumed daily, number of previous AWS episodes, number of alcohol-related emergency department visits, Charlson index, cocaine consumption, consumption of a drug other than alcohol and the reason for hospitalization. The independent variables related to the risk of complicated AWS were low education level (illiterate or primary studies compared with secondary or university education), hospitalization for AWS and drug abuse other than alcohol (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). The model's receiver operating characteristic area was 0.718 (95% CI 0.643–0.793).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionThe profile of a patient with AWS treated in an internal medicine department is a middle-aged man who drinks wine and beer and has a long history of alcohol consumption and previous failed attempts at detoxification. This patient is also a regular user of healthcare facilities, is unemployed or retired and has a low education level and little family support.In recent years, the mean consumption of wine per capita has fallen in Spain, while that of beer has increased. The consumption of spirits has remained stable.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Patients with AWS belong to the 25–64-year age group. The types of alcohol most often consumed are beer (53%) and wine (34%).<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> In terms of sex, men drink more frequently and in greater volumes than women. The most recent surveys on alcohol consumption in Spain show a prevalence of daily consumption up to 3-fold greater in males of all age groups.<a class="elsevierStyleCrossRefs" href="#bib0050">10,12</a> Consequently, all studies on AWS have shown a predominance of the male sex, between 80% and 90% of cases,<a class="elsevierStyleCrossRefs" href="#bib0020">4,6,13</a> results similar to those recorded in this study. Recent data have alerted us to the increase in alcohol consumption among young women in Spain and in other countries,<a class="elsevierStyleCrossRefs" href="#bib0055">11,14</a> which might change this distribution in the future.Studies have indicated that patients with AWS have an irregular pattern of alcohol consumption and that this pattern can be associated with varying degrees of hepatic lesions (alcoholic hepatitis) compared with those of patients with regular alcohol consumption (hepatic cirrhosis).<a class="elsevierStyleCrossRef" href="#bib0075">15</a> In contrast, our study recorded 83% of cases with regular alcohol consumption, similar findings to those of surveys on alcohol consumption in Spain, which observed that alcohol consumption in men is concentrated in traditional daily drinking (85%), while that of women is most common during the weekends (56%).<a class="elsevierStyleCrossRefs" href="#bib0050">10–12</a> In any case, it is likely that this aspect is difficult to determine during interviews of patients with alcohol dependence, in which the quantities and frequencies of consumption are frequently underestimated.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>The association between socioeconomic conditions and the pattern of alcohol consumption varies according to the indicator being measured. The frequency of alcohol consumption is greater in individuals with a higher education level. If we consider the amount, which is especially relevant for patients with AWS, the quantity consumed is inversely related to education level.<a class="elsevierStyleCrossRefs" href="#bib0050">10–12,17,18</a> This relationship is not homogeneous in terms of sex. The surveys in Spain have shown that the prevalence of male heavy drinkers is inversely proportional to education level. In contrast, hazardous drinking by women is lower at lower educational levels and higher in the higher social classes.<a class="elsevierStyleCrossRefs" href="#bib0050">10–12</a> Although they do not refer to patients with alcohol dependence, these differences could explain the results from other studies that assessed the relationship between the population's educational level and the rate of hospitalization for AWS, observing a negative correlation between the two.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> Moreover, studies have reported that a low educational level is associated with poorer results after alcohol detoxification treatment<a class="elsevierStyleCrossRef" href="#bib0040">8</a> and to a higher rate of readmissions for AWS.<a class="elsevierStyleCrossRef" href="#bib0095">19</a>This study provides new data, indicating that a low educational level is independently associated with the risk of developing complicated AWS. This factor has not been previously considered in the analysis of predictors of severe AWS in hospitalized patients.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> This condition might be associated with a more intense pattern of alcohol consumption that increases the risk not only of AWS but also of severe complications.Other sociodemographic factors, such as an unstructured employment status and family status, did not affect the risk of having complicated AWS in the hospitalized patients. Although these variables can determine the long-term results of detoxification treatment and the state of addiction,<a class="elsevierStyleCrossRefs" href="#bib0100">20–22</a> the results of the present study confirm those obtained by another study that also observed no relationship between these factors and the rate of short-term AWS outpatient treatment failure.<a class="elsevierStyleCrossRef" href="#bib0030">6</a>Patients who are admitted to medical areas for AWS usually have advanced symptoms upon their arrival at the hospital.<a class="elsevierStyleCrossRefs" href="#bib0020">4,23</a> Nevertheless, in our study, 60% of the patients developed AWS after a hospitalization for another reason, which probably indicates a deficiency in the early hospital detection of this syndrome, as has been already reported.<a class="elsevierStyleCrossRefs" href="#bib0010">2,24</a> This finding represents a lost opportunity for adopting preventive measures to decrease the risk of AWS.<a class="elsevierStyleCrossRefs" href="#bib0125">25,26</a>The importance of the abuse of other drugs during the course of AWS has been poorly studied. Studies have reported that concomitant dependence on other abused drugs (opioids, hypnotics, cannabis, cocaine) is associated with the presence of DT and seizures.<a class="elsevierStyleCrossRef" href="#bib0135">27</a> However, other studies have indicated that dependence on cocaine does not change the severity of the AWS but rather decreases the risk of seizures and the need for sedative treatment.<a class="elsevierStyleCrossRefs" href="#bib0140">28–30</a> These results vary if the recent consumption of cocaine is considered, which has been related to the development of more severe forms of AWS.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> It is possible that patients who consume other drugs, especially cocaine, have more intense patterns of alcohol intake in terms of quantity and frequency<a class="elsevierStyleCrossRef" href="#bib0155">31</a> and that this is the cause of the relationship observed in the study.This study had a number of limitations. The recorded data are circumscribed to internal medicine departments, which means that not all patients with AWS in each hospital were included in the study, because many of the centers treat these patients in other departments (Psychiatry, Gastrointestinal, Neurology, etc.). In this respect, the patients hospitalized in internal medicine departments have greater comorbidity and possibly more severe AWS conditions. These patients’ clinical profile also differs from that of patients admitted to special alcoholism or detoxification units, which are also not represented in the study. All of these aspects entail a selection bias, as does the fact that the representation of hospitals that collaborated in the study does not include all the autonomous communities of Spain. Moreover, the data regarding the quantity of alcohol consumed, years of dependence and patterns of consumption are difficult to ensure during the interviews with patients with alcohol dependence, which could bias the results. Ultimately, for a number of variables with low incidence rates (e.g., consumption of opioids), the sample size could limit the interpretation of the results.In conclusion, it is not easy to identify the factors related to the habit of alcohol consumption and complicated AWS. However, factors such as educational level and the consumption of other abused drugs could help identify patients with the risk of developing more severe forms of AWS.FundingThe database management was funded by the Alcohol and Alcoholism Workgroup of the Spanish Society of Internal Medicine. The investigators received no remuneration for their participation in the study.Authors/CollaboratorsCollaborating investigators: L. García-Pereña (University Hospital San Cecilio, Granada), F. Epelde (University Hospital Parc Tauli, Sabadell), R. Gómez-Méndez (University Hospital Lucus Augusti, Lugo) and AJ Chamorro-Fernández (University Hospital, Salamanca).Conflict of interestsThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres907005" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec887287" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres907004" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec887288" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Authors/Collaborators" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-11-30" "fechaAceptado" => "2017-05-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec887287" "palabras" => array:4 [ 0 => "Alcohol withdrawal syndrome" 1 => "Epidemiology" 2 => "Educational level" 3 => "Risk factors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec887288" "palabras" => array:4 [ 0 => "Síndrome de abstinencia alcohólica" 1 => "Epidemiología" 2 => "Nivel educativo" 3 => "Factores de riesgo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesTo analyze the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). Material and methodsA multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens. ResultsWe studied 228 episodes of AWS in 219 patients. The mean age was 54.5 years (SD, 11.5), and 90.8% were men. AWS was the cause for hospitalization in 39.9% of the patients. Some 27.1% of the cases presented seizures, and 32.4% presented delirium tremens. The daily quantity of alcohol ingested was 17.8 standard drink units (SD, 21.4), with 16.6 years of dependence (SD, 11.3). The pattern of alcohol abuse was regular in 82.8% of the patients. Some 38.4% of the patients were married or had a partner, and 45.6% had children. Some 72.7% of the patients were unemployed or retired. Some 68.5% had only completed primary studies. Some 4.8% consumed cannabis, 5.2% consumed cocaine and 3% consumed opioids. The independent variables related to complicated AWS were consumption of a drug other than alcohol (OR, 5.3; 95% CI 1.5–18.7), low education level (OR, 3.4; 95% CI 1.6–7.3) and hospitalization for AWS (OR, 2.9; 95% CI 1.5–5.6). The model's receiver operating characteristic area was 0.718 (95% CI 0.643–0.793). ConclusionsConcomitant drug abuse and a low educational level could help identify patients at risk of complicated AWS." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosAnalizar la influencia de los factores epidemiológicos y sociodemográficos en el síndrome de abstinencia alcohólica (SAA) complicado. Material y métodosEstudio multicéntrico, observacional, prospectivo de enfermos consecutivos con SAA ingresados en servicios de Medicina Interna. Se registraron datos sociodemográficos, epidemiológicos, clínicos y evolutivos. Se definió SAA complicado como aquel que había cursado con convulsiones o delirium tremens. ResultadosSe estudiaron 228 episodios de SAA en 219 pacientes. La edad media fue de 54,5 años (DE 11,5), y el 90,8% fueron hombres. El SAA fue la causa de ingreso en el 39,9%. El 27,1% de los casos presentaron crisis comiciales y el 32,4% delirium tremens. La cantidad ingerida de alcohol diaria fue 17,8 unidades de bebida estándar (DE 21,4), con 16,6 años de dependencia (DE 11,3). El patrón de abuso de alcohol fue regular en el 82,8%. Vivían casados o en pareja el 38,4% y el 45,6% tenía hijos. Un 72,7% estaba en paro o era pensionista. El 68,5% solo habían cursado estudios primarios. El 4,8% consumía cannabis, 5,2% cocaína y 3% opiáceos. Las variables independientes relacionadas con SAA complicado fueron: consumo de alguna droga diferente del alcohol (OR 5,3; IC 95% 1,5-18,7), bajo nivel de estudios (OR 3,4; IC 95% 1,6-7,3) y el ingreso por SAA (OR 2,9; IC 95% 1,5-5,6). El área ROC del modelo fue de 0,718 (IC 95% 0,643-0,793). ConclusionesEl consumo concomitante de otras drogas de abuso y el nivel bajo de estudios pueden ayudar en la identificación de pacientes con riesgo de SAA complicado." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Monte-Secades R, Blanco-Soto M, Díaz-Peromingo JA, Sanvisens-Bergé A, Martín-González MC, Barbosa A, et al. Factores epidemiológicos y sociodemográficos asociados al síndrome de abstinencia alcohólica complicado. Rev Clin Esp. 2017;217:381–386." ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: CI, confidence interval; RR, relative risk; AWS, alcohol withdrawal syndrome." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">AWS, n=118 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">Complicated AWS, n=110 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">RR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Years of alcohol consumption \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">28.8 (14.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">28.7 (12.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Years of alcohol dependence<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">16.9 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">16.4 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Grams of alcohol daily<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">153.9 (100.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">190.7 (135.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Standard beverage units/day<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">15.6 (23.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">20.3 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">No. of attempts at detoxification<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.6 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">No. of previous AWS<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.5 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">1.4 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">No. of emergency department visits<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.5 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">1.1 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Intake of spirits, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">44 (37.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">34 (30.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.7 (0.4–1.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Regular intake pattern, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">100 (52.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">89 (47.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.8 (0.5–1.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Smoker, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">79 (66.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">71 (64.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.8 (0.4–1.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Cannabis consumption, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">4 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">7 (6.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">1.8 (0.5–6.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Cocaine consumption, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">2 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">10 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.03 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">5.3 (1.1–25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Opioid consumption, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">2 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">5 (4.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">2.5 (0.4–13.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Use of synthetic drugs, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">3 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">0.5 (0.4–0.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Drug abuse other than alcohol, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">4 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">15 (13.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">4 (1.3–12.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Charlson index<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">1.9 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">2.1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="middle">Hospitalization for AWS, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">31 (26.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">60 (54.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="middle">3.3 (1.9–5.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525502.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Number of alcohol consumption-related visits to hospital emergency departments in the 12 months prior to admission." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Mean (SD)." ] ] ] "descripcion" => array:1 [ "en" => "Epidemiological characteristics related to uncomplicated and complicated alcohol withdrawal syndrome (seizures or delirium tremens)." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: CI, confidence interval; RR, relative risk; AWS, alcohol withdrawal syndrome." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AWS, n=118 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complicated AWS, n=110 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years (SD)<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.2 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.6 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.018 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">109 (92.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 (89.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.4 (0.5–3.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospital >500 beds, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83 (70.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (62.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7 (0.4–1.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Population <10,000 inhabs, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 (41.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 (34.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.5 (0.8–2.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Single, separated or widowed, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 (59.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (64.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2 (0.7–2.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Has children, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55 (46.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 (45.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.3 (0.6–2.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unemployed or retired, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82 (74.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82 (78.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2 (0.6–2.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Illiterate or primary studies, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 (58.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74 (78.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6 (1.3–4.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525503.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "Mean (SD)." ] ] ] "descripcion" => array:1 [ "en" => "Demographic characteristics of patients with uncomplicated and complicated alcohol withdrawal syndrome (seizures or delirium tremens)." ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Abbreviations: CI, confidence interval; AWS, alcohol withdrawal syndrome; OR, odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Studies (illiterate or primary studies vs. secondary or university) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.6–7.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospitalization for AWS (vs. hospitalization for other reasons) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.5–5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Consumption of a drug other than alcohol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.5–18.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1525504.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate analysis for the development of complicated alcohol withdrawal syndrome (seizures or delirium tremens)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Global status report on alcohol and health-2014 ed." ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2014" "editorial" => "World Health Organization" "editorialLocalizacion" => "Luxembourg" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence and routine assessment of unhealthy alcohol use in hospitalized patients" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ASMI Study Group" "etal" => true "autores" => array:6 [ 0 => "B. Rosón" 1 => "R. Monte" 2 => "R. Gamallo" 3 => "R. Puerta" 4 => "A. Zapatero" 5 => "J. Fernández-Solá" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejim.2010.04.006" "Revista" => array:6 [ "tituloSerie" => "Eur J Intern Med" "fecha" => "2010" "volumen" => "21" "paginaInicial" => "458" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20816605" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genome-wide association study of alcohol dependence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Treutlein" 1 => "S. Cichon" 2 => "M. Ridinger" 3 => "N. Wodarz" 4 => "M. Soyka" 5 => "P. Zill" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archgenpsychiatry.2009.83" "Revista" => array:6 [ "tituloSerie" => "Arch Gen Psychiatry" "fecha" => "2009" "volumen" => "66" "paginaInicial" => "773" "paginaFinal" => "784" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19581569" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for delirium tremens in patients with alcohol withdrawal syndrome in a hospital setting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Monte" 1 => "R. Rabuñal" 2 => "E. Casariego" 3 => "M. Bal" 4 => "S. Pértega" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejim.2009.07.008" "Revista" => array:6 [ "tituloSerie" => "Eur J Intern Med" "fecha" => "2009" "volumen" => "20" "paginaInicial" => "690" "paginaFinal" => "694" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19818288" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of severe alcohol withdrawal syndrome: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.M. Goodson" 1 => "B.J. Clark" 2 => "I.S. Douglas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/acer.12529" "Revista" => array:6 [ "tituloSerie" => "Alcohol Clin Exp Res" "fecha" => "2014" "volumen" => "38" "paginaInicial" => "2664" "paginaFinal" => "2677" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25346507" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social and clinical features as predictors of outcome in outpatient alcohol withdrawal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.G. O’Connor" 1 => "L.D. Gottlieb" 2 => "M.L. Kraus" 3 => "S.R. Segal" 4 => "R.I. Horwitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Gen Intern Med" "fecha" => "1991" "volumen" => "6" "paginaInicial" => "312" "paginaFinal" => "316" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1890501" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Predictionof Alcohol Withdrawal Severity Scale (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Maldonado" 1 => "Y. Sher" 2 => "J.F. Ashouri" 3 => "K. Hills-Evans" 4 => "H. Swendsen" 5 => "S. Lolak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.alcohol.2014.01.004" "Revista" => array:6 [ "tituloSerie" => "Alcohol" "fecha" => "2014" "volumen" => "48" "paginaInicial" => "375" "paginaFinal" => "390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24657098" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of drinking and functional outcomes for men and women following inpatient alcohol treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.E. Sugarman" 1 => "J.S. Kaufman" 2 => "E.M. Trucco" 3 => "J.C. Brown" 4 => "S.F. Greenfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1521-0391.2014.12098.x" "Revista" => array:6 [ "tituloSerie" => "Am J Addict" "fecha" => "2014" "volumen" => "23" "paginaInicial" => "226" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24724879" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and statistical manual of mental disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "American Psychiatric Association" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "4th ed. rev." "fecha" => "2000" "editorial" => "American Psychiatric Association" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Encuesta Nacional de S. Serie informes monográficos n.°1. Consumo de alcohol" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "Ministerio de Sanidad, Servicios sociales e Igualdad" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "EDADES 2011/12. Delegación del Gobierno para el Plan Nacional sobre Drogas" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "Ministerio de Sanidad, Servicios Sociales e Igualdad" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Encuesta Europea de Salud en España 2014" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2015" "editorial" => "Instituto Nacional de Estadística/Ministerio de Sanidad, Servicios Sociales e Igualdad" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Temporal and spatial patterns in the rate of alcohol withdrawal syndrome in a defined community" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Gonzalez-Quintela" 1 => "S. Fernández-Conde" 2 => "M.T. Alves" 3 => "J. Campos" 4 => "M. Lopez-Raton" 5 => "R. Puerta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.alcohol.2010.08.001" "Revista" => array:6 [ "tituloSerie" => "Alcohol" "fecha" => "2011" "volumen" => "45" "paginaInicial" => "105" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20843642" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L. Ng Fat" 1 => "E. Fuller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "fecha" => "2012" "paginaInicial" => "207" "paginaFinal" => "252" "editorial" => "The Health and Social Care Information Centre" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Liver disease in heavy drinkers with and without alcohol withdrawal syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Barrio" 1 => "S. Tomé" 2 => "I. Rodríguez" 3 => "F. Gude" 4 => "J. Sánchez-Leira" 5 => "E. Pérez-Becerra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ALC.0000106301.39746.EB" "Revista" => array:6 [ "tituloSerie" => "Alcohol Clin Exp Res" "fecha" => "2004" "volumen" => "28" "paginaInicial" => "131" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14745311" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of alcohol consumption by mailed questionnaire in epidemiological studies: evaluation of misclassification using a dietary history interview and biochemical markers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Carlsson" 1 => "N. Hammar" 2 => "P. Hakala" 3 => "J. Kaprio" 4 => "J. Marniemi" 5 => "T. Rönnemaa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Epidemiol" "fecha" => "2003" "volumen" => "18" "paginaInicial" => "493" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12908714" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action ‘Gender, Culture and Alcohol Problems: a Multi-national Study’" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Bloomfield" 1 => "U. Grittner" 2 => "S. Kramer" 3 => "G. Gmel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/alcalc/agl073" "Revista" => array:6 [ "tituloSerie" => "Alcohol Alcohol Suppl" "fecha" => "2006" "volumen" => "41" "paginaInicial" => "i26" "paginaFinal" => "i36" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17030500" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends and determinants of alcohol consumption in Portugal: results from the national health surveys 1995 to 1996 and 1998 to 1999" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Marques-Vidal" 1 => "C.M. Dias" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Alcohol Clin Exp Res" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "89" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15654297" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiple admissions for alcohol withdrawal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. Larson" 1 => "M.C. Burton" 2 => "D.T. Kashiwagi" 3 => "Z.P. Hugo" 4 => "S.S. Cha" 5 => "M.I. Lapid" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jhm.1953" "Revista" => array:6 [ "tituloSerie" => "J Hosp Med" "fecha" => "2012" "volumen" => "7" "paginaInicial" => "617" "paginaFinal" => "621" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22791681" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The detoxification experience of alcoholic in-patients and predictors of outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.K. Shaw" 1 => "S. Waller" 2 => "C.J. Latham" 3 => "G. Dunn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Alcohol Alcohol" "fecha" => "1998" "volumen" => "33" "paginaInicial" => "291" "paginaFinal" => "303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9632055" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social factors but not stress-coping styles predict relapse in detoxified alcoholics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Walter" 1 => "U. Gerhard" 2 => "K.M. Duersteler-MacFarland" 3 => "H.G. Weijers" 4 => "J. Boening" 5 => "G.A. Wiesbeck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000096991" "Revista" => array:6 [ "tituloSerie" => "Neuropsychobiology" "fecha" => "2006" "volumen" => "54" "paginaInicial" => "100" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17108710" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unemployment and substance outcomes in the United States 2002–2010" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.M. Compton" 1 => "J. Gfroerer" 2 => "K.P. Conway" 3 => "M.S. Finger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.drugalcdep.2014.06.012" "Revista" => array:6 [ "tituloSerie" => "Drug Alcohol Depend" "fecha" => "2014" "volumen" => "142" "paginaInicial" => "350" "paginaFinal" => "353" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25042761" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manifestaciones y curso clínico del síndrome de abstinencia alcohólica en un hospital general" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Monte Secades" 1 => "E. Casariego Vales" 2 => "S. Pértega Díaz" 3 => "R. Rabuñal Rey" 4 => "M. Peña Zemsch" 5 => "S. Pita Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2008" "volumen" => "208" "paginaInicial" => "506" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19100132" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence, clinical characteristics, and risk factors for non-recording of alcohol use in hospitals across Europe: The ALCHIMIE Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Rosón" 1 => "X. Corbella" 2 => "P. Perney" 3 => "A. Santos" 4 => "R. Stauber" 5 => "M. Lember" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/alcalc/agv142" "Revista" => array:6 [ "tituloSerie" => "Alcohol Alcohol" "fecha" => "2016" "volumen" => "51" "paginaInicial" => "457" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26818195" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal" "etal" => false "autores" => array:1 [ 0 => "M.F. Mayo-Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1997" "volumen" => "278" "paginaInicial" => "144" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9214531" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective validation study of the prediction of alcohol withdrawal severity scale (PAWSS) in medically ill inpatients: a new scale for the Prediction of Complicated Alcohol Withdrawal Syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Maldonado" 1 => "Y. Sher" 2 => "S. Das" 3 => "K. Hills-Evans" 4 => "A. Frenklach" 5 => "S. Lolak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/alcalc/agv043" "Revista" => array:6 [ "tituloSerie" => "Alcohol Alcohol" "fecha" => "2015" "volumen" => "50" "paginaInicial" => "509" "paginaFinal" => "518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25999438" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The histories of withdrawal convulsions and delirium tremens in 1648 alcohol dependent subjects" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.A. Schuckit" 1 => "J.E. Tipp" 2 => "T. Reich" 3 => "V.M. Hesselbrock" 4 => "K.K. Bucholz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Addiction" "fecha" => "1995" "volumen" => "90" "paginaInicial" => "1335" "paginaFinal" => "1347" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8616462" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Concurrent cocaine withdrawal alters alcohol withdrawal symptoms" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.M. Kampman" 1 => "H. Pettinati" 2 => "J. Volpicelli" 3 => "G. Kaempf" 4 => "E. Turk" 5 => "A. Insua" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1300/J069v21n04_02" "Revista" => array:6 [ "tituloSerie" => "J Addict Dis" "fecha" => "2002" "volumen" => "21" "paginaInicial" => "13" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12296498" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alcohol-related seizures and the kindling effect of repeated detoxifications: the influence of cocaine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.H. Moak" 1 => "R.F. Anton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Alcohol Alcohol" "fecha" => "1996" "volumen" => "31" "paginaInicial" => "135" "paginaFinal" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8737008" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Concurrent cocaine withdrawal is associated with reduced severity of alcohol withdrawal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Castaneda" 1 => "H. Lifshutz" 2 => "L. Westreich" 3 => "M. Galanter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Compr Psychiatry" "fecha" => "1995" "volumen" => "36" "paginaInicial" => "441" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8565449" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alcohol dependence among cocaine-dependent outpatients: demographics, drug use, treatment outcome and other characteristics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.H. Heil" 1 => "G.J. Badger" 2 => "S.T. Higgins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Stud Alcohol" "fecha" => "2001" "volumen" => "62" "paginaInicial" => "14" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11271960" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021700000007/v1_201709280051/S2254887417300796/v1_201709280051/en/main.assets" "Apartado" => array:4 [ "identificador" => "1901" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021700000007/v1_201709280051/S2254887417300796/v1_201709280051/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300796?idApp=WRCEE"]

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Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome

Factores epidemiológicos y sociodemográficos asociados al síndrome de abstinencia alcohólica complicado

R. Monte-Secadesa,

Corresponding author

rafael.monte.secades@sergas.es

Corresponding author.

, M. Blanco-Sotob, J.A. Díaz-Peromingoc, A. Sanvisens-Bergéd, M.C. Martín-Gonzáleze, A. Barbosaf, B. Rosón-Hernándezg, M.A. Tejero-Delgadoh, R. Puerta-Louroi, R. Rabuñal-Reya, Grupo de Trabajo Alcohol y Alcoholismo, Sociedad Española de Medicina Interna

a Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, Spain

b Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain

c Medicina Interna, Complejo Hospitalario Universitario, Santiago de Compostela, Spain

d Medicina Interna, Hospital Universitari Germans Trías i Pujol, Badalona, Spain

e Medicina Interna, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Spain

f Medicina Interna, Hospital Universitario, Salamanca, Spain

g Medicina Interna, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

h Medicina Interna, Hospital Cabueñes, Gijón, Spain

i Medicina Interna, Hospital POVISA, Vigo, Spain

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Of these&#44; some develop alcohol withdrawal syndrome &#40;AWS&#41; of variable intensity when they stop drinking&#46; There are numerous factors that likely influence this variability&#58; genetic&#44; epidemiological&#44; clinical&#44; sociodemographic&#44; etc&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;6</span></a> Studies have indicated that the course of previous AWS episodes is the most reliable predictor of the progression of subsequent episodes&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> However&#44; the involvement of other comorbidities is unclear&#44; as are the clinical or analytical factors associated with the most severe forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;7</span></a> Moreover&#44; the influence of sociodemographic factors on the long-term success of alcohol detoxification treatment has been assessed&#44;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;8</span></a> but their influence on the clinical course of the AWS itself is unknown&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study is to analyze the influence of epidemiological and sociodemographic factors on the development of complicated AWS at hospital admission&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a multicenter&#44; observational&#44; prospective registry of patients with AWS&#44; hospitalized consecutively in 12 Spanish internal medicine departments&#44; from January 1&#44; 2013 to December 31&#44; 2014&#46; The diagnosis of AWS and <span class="elsevierStyleItalic">delirium tremens</span> &#40;DT&#41; was established according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders &#40;Fourth Edition&#44; Text Revision&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> The study was approved by the ethics committees of all participating centers&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We recorded sociodemographic&#44; epidemiological&#44; clinical and progression data in a database created for this purpose&#46; We defined the pattern of regular alcohol abuse as the intake of constant daily quantities&#46; The pattern of irregular alcohol abuse was defined as the intake of variable quantities&#44; in peaks and valleys&#44; over the course of days or weeks&#44; for the 6 months prior to admission&#46; Complicated alcohol withdrawal was defined as that which progressed with seizures or DT&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0030" class="elsevierStylePara elsevierViewall">We performed a descriptive study of the variables&#46; To identify the predictors&#44; we compared the means using Student&#39;s <span class="elsevierStyleItalic">t</span>-test and&#47;or the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test after determining the normality and homogeneity of the variances&#46; For the qualitative variables&#44; we used the chi-squared test and Fisher&#39;s exact test when the cells contained values less than 5&#46; We considered the level of statistical significance to be less than 0&#46;05&#46; We performed a logistic regression analysis to study the degree of association between the various factors and complicated AWS&#46; We calculated the adjusted odds ratio values and their respective confidence intervals&#46; The statistical analysis was conducted with the SPSS<span class="elsevierStyleSup">&#174;</span> 15 statistics software package&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">We studied 228 episodes of hospitalization with AWS in 219 patients&#46; The mean age was 54&#46;4 years &#40;SD&#44; 11&#46;5&#41;&#44; and most of the participants &#40;207&#44; 90&#46;8&#37;&#41; were men&#46; AWS was the cause for hospitalization in 91 cases &#40;39&#46;9&#37;&#41;&#44; and 137 &#40;60&#46;1&#37;&#41; were hospitalized for other reasons but developed AWS during their stay&#46; Seizures were recorded in 62 cases &#40;27&#46;1&#37;&#41;&#44; which were generalized in 53 &#40;85&#46;4&#37;&#41; cases&#44; partial secondarily generalized in 7 &#40;11&#46;3&#37;&#41; cases and partial in 2 cases &#40;3&#46;2&#37;&#41;&#46; Seventy-four &#40;32&#46;4&#37;&#41; episodes progressed with DT&#46; The mean Charlson index was 2 &#40;SD&#44; 1&#46;8&#41;&#46; Fifty-two &#40;22&#46;8&#37;&#41; patients were admitted to the intensive care unit&#44; and the mean hospital stay was 15&#46;6 days &#40;SD&#44; 27&#46;8&#41;&#46; The most common treatment regimen was fixed plus rescue dosage &#40;71&#37;&#41;&#44; followed by fixed dosage &#40;25&#37;&#41;&#46; Some 89&#46;9&#37; of the patients were treated with benzodiazepines&#44; 42&#46;9&#37; with neuroleptics&#44; 22&#46;8&#37; with clomethiazole and 14&#46;4&#37; with propofol&#46; There were 5 deaths &#40;2&#46;1&#37;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The daily alcohol intake was 173&#46;3<span class="elsevierStyleHsp" style=""></span>g &#40;SD&#44; 120&#46;9&#41; or 17&#46;8 standard drink units &#40;SD&#44; 21&#46;4&#41;&#44; with a mean duration of alcohol consumption of 28&#46;7 years &#40;SD&#44; 13&#46;5&#41; and of dependence of 16&#46;6 years &#40;SD&#44; 11&#46;3&#41;&#46; Wine was the most common beverage in the patients who consumed a single type of alcohol&#44; with 64 cases &#40;28&#37;&#41;&#44; followed by beer with 33 &#40;14&#46;4&#37;&#41; cases and spirits with 18 &#40;7&#46;8&#37;&#41;&#46; Multiple consumption of alcoholic beverages was recorded in 111 patients &#40;48&#46;6&#37;&#41;&#46; Of these&#44; the most common combination was wine and beer &#40;29&#46;7&#37;&#41;&#44; followed by wine&#44; beer and spirits &#40;25&#46;2&#37;&#41;&#46; A total of 72 patients &#40;31&#46;5&#37;&#41; had undergone failed detoxification programs&#44; and 71 &#40;31&#46;1&#37;&#41; patients had previously experienced AWS with hospitalization&#46; During the 12 months prior to the index admission&#44; hospital emergency department visits for alcohol consumption were recorded for 62 patients &#40;27&#46;1&#37;&#41;&#46; The pattern of alcohol abuse was documented in 219 cases&#44; of which 189 were regular &#40;82&#46;8&#37;&#41; and 30 were irregular &#40;13&#46;1&#37;&#41;&#46; One hundred and fifty patients consumed tobacco &#40;65&#46;7&#37;&#41;&#44; 11 &#40;4&#46;8&#37;&#41; consumed cannabis&#44; 12 &#40;5&#46;2&#37;&#41; consumed cocaine&#44; 7 &#40;3&#37;&#41; consumed opioids&#44; and 3 &#40;1&#46;3&#37;&#41; consumed synthetic drugs&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We recorded the marital status in 216 cases&#59; of these&#44; 83 &#40;38&#46;4&#37;&#41; were married or lived with a partner&#44; 47 &#40;20&#46;4&#37;&#41; were separated&#44; 78 &#40;36&#46;1&#37;&#41; were single&#44; and 8 &#40;3&#46;4&#37;&#41; were widowers&#46; Some 45&#46;6&#37; of the patients had children&#46; At admission&#44; 51 patients &#40;22&#46;3&#37;&#41; were employed&#44; 81 &#40;35&#46;5&#37;&#41; were unemployed&#44; and 85 were retired &#40;37&#46;2&#37;&#41;&#46; The marital status of 13 &#40;5&#46;7&#37;&#41; patients was unknown&#46; The education level was determined in 194 patients&#58; 23 &#40;11&#46;8&#37;&#41; had no formal education&#44; 110 &#40;56&#46;7&#37;&#41; had primary education&#44; 55 &#40;28&#46;3&#37;&#41; had secondary &#40;high school diploma or equivalent or professional training&#41;&#44; and 6 had university education &#40;3&#46;1&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We identified 110 episodes of complicated AWS&#46; The epidemiological characteristics regarding alcohol consumption in this group compared with those of uncomplicated AWS &#40;118 cases&#41; are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The patients with complicated AWS had a tendency toward greater alcohol consumption &#40;in terms of volume&#41; and a higher number of previous hospitalizations for AWS and hospital emergency department visits&#46; The concomitant consumption of cocaine and drug abuse other than alcohol &#40;cannabis&#44; opioids&#44; synthetic drugs or cocaine&#41; was associated with a greater risk of complicated AWS&#44; as was hospitalization prompted by AWS&#46; There were no differences in terms of the type of alcoholic beverage&#44; the years of dependence or the pattern of intake&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The demographic characteristics of both groups are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The patients with complicated AWS were younger&#44; but there were no differences in terms of sex&#44; size of the hospital of origin or the patients&#8217; population setting&#46; We also observed no associations with marital status or employment status&#46; However&#44; the patients with a lower education level &#40;illiterate or primary studies&#41; had a greater chance of presenting seizures or DT&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The multivariate analysis included the variables age&#44; sex&#44; education level&#44; employment status&#44; marital status&#44; years of consumption&#44; grams of alcohol consumed daily&#44; number of previous AWS episodes&#44; number of alcohol-related emergency department visits&#44; Charlson index&#44; cocaine consumption&#44; consumption of a drug other than alcohol and the reason for hospitalization&#46; The independent variables related to the risk of complicated AWS were low education level &#40;illiterate or primary studies compared with secondary or university education&#41;&#44; hospitalization for AWS and drug abuse other than alcohol &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The model&#39;s receiver operating characteristic area was 0&#46;718 &#40;95&#37; CI 0&#46;643&#8211;0&#46;793&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">The profile of a patient with AWS treated in an internal medicine department is a middle-aged man who drinks wine and beer and has a long history of alcohol consumption and previous failed attempts at detoxification&#46; This patient is also a regular user of healthcare facilities&#44; is unemployed or retired and has a low education level and little family support&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In recent years&#44; the mean consumption of wine per capita has fallen in Spain&#44; while that of beer has increased&#46; The consumption of spirits has remained stable&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Patients with AWS belong to the 25&#8211;64-year age group&#46; The types of alcohol most often consumed are beer &#40;53&#37;&#41; and wine &#40;34&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> In terms of sex&#44; men drink more frequently and in greater volumes than women&#46; The most recent surveys on alcohol consumption in Spain show a prevalence of daily consumption up to 3-fold greater in males of all age groups&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;12</span></a> Consequently&#44; all studies on AWS have shown a predominance of the male sex&#44; between 80&#37; and 90&#37; of cases&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;6&#44;13</span></a> results similar to those recorded in this study&#46; Recent data have alerted us to the increase in alcohol consumption among young women in Spain and in other countries&#44;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;14</span></a> which might change this distribution in the future&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Studies have indicated that patients with AWS have an irregular pattern of alcohol consumption and that this pattern can be associated with varying degrees of hepatic lesions &#40;alcoholic hepatitis&#41; compared with those of patients with regular alcohol consumption &#40;hepatic cirrhosis&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> In contrast&#44; our study recorded 83&#37; of cases with regular alcohol consumption&#44; similar findings to those of surveys on alcohol consumption in Spain&#44; which observed that alcohol consumption in men is concentrated in traditional daily drinking &#40;85&#37;&#41;&#44; while that of women is most common during the weekends &#40;56&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> In any case&#44; it is likely that this aspect is difficult to determine during interviews of patients with alcohol dependence&#44; in which the quantities and frequencies of consumption are frequently underestimated&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The association between socioeconomic conditions and the pattern of alcohol consumption varies according to the indicator being measured&#46; The frequency of alcohol consumption is greater in individuals with a higher education level&#46; If we consider the amount&#44; which is especially relevant for patients with AWS&#44; the quantity consumed is inversely related to education level&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12&#44;17&#44;18</span></a> This relationship is not homogeneous in terms of sex&#46; The surveys in Spain have shown that the prevalence of male heavy drinkers is inversely proportional to education level&#46; In contrast&#44; hazardous drinking by women is lower at lower educational levels and higher in the higher social classes&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> Although they do not refer to patients with alcohol dependence&#44; these differences could explain the results from other studies that assessed the relationship between the population&#39;s educational level and the rate of hospitalization for AWS&#44; observing a negative correlation between the two&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Moreover&#44; studies have reported that a low educational level is associated with poorer results after alcohol detoxification treatment<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and to a higher rate of readmissions for AWS&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">This study provides new data&#44; indicating that a low educational level is independently associated with the risk of developing complicated AWS&#46; This factor has not been previously considered in the analysis of predictors of severe AWS in hospitalized patients&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> This condition might be associated with a more intense pattern of alcohol consumption that increases the risk not only of AWS but also of severe complications&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Other sociodemographic factors&#44; such as an unstructured employment status and family status&#44; did not affect the risk of having complicated AWS in the hospitalized patients&#46; Although these variables can determine the long-term results of detoxification treatment and the state of addiction&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a> the results of the present study confirm those obtained by another study that also observed no relationship between these factors and the rate of short-term AWS outpatient treatment failure&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Patients who are admitted to medical areas for AWS usually have advanced symptoms upon their arrival at the hospital&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;23</span></a> Nevertheless&#44; in our study&#44; 60&#37; of the patients developed AWS after a hospitalization for another reason&#44; which probably indicates a deficiency in the early hospital detection of this syndrome&#44; as has been already reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;24</span></a> This finding represents a lost opportunity for adopting preventive measures to decrease the risk of AWS&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The importance of the abuse of other drugs during the course of AWS has been poorly studied&#46; Studies have reported that concomitant dependence on other abused drugs &#40;opioids&#44; hypnotics&#44; cannabis&#44; cocaine&#41; is associated with the presence of DT and seizures&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> However&#44; other studies have indicated that dependence on cocaine does not change the severity of the AWS but rather decreases the risk of seizures and the need for sedative treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#8211;30</span></a> These results vary if the recent consumption of cocaine is considered&#44; which has been related to the development of more severe forms of AWS&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> It is possible that patients who consume other drugs&#44; especially cocaine&#44; have more intense patterns of alcohol intake in terms of quantity and frequency<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> and that this is the cause of the relationship observed in the study&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">This study had a number of limitations&#46; The recorded data are circumscribed to internal medicine departments&#44; which means that not all patients with AWS in each hospital were included in the study&#44; because many of the centers treat these patients in other departments &#40;Psychiatry&#44; Gastrointestinal&#44; Neurology&#44; etc&#46;&#41;&#46; In this respect&#44; the patients hospitalized in internal medicine departments have greater comorbidity and possibly more severe AWS conditions&#46; These patients&#8217; clinical profile also differs from that of patients admitted to special alcoholism or detoxification units&#44; which are also not represented in the study&#46; All of these aspects entail a selection bias&#44; as does the fact that the representation of hospitals that collaborated in the study does not include all the autonomous communities of Spain&#46; Moreover&#44; the data regarding the quantity of alcohol consumed&#44; years of dependence and patterns of consumption are difficult to ensure during the interviews with patients with alcohol dependence&#44; which could bias the results&#46; Ultimately&#44; for a number of variables with low incidence rates &#40;e&#46;g&#46;&#44; consumption of opioids&#41;&#44; the sample size could limit the interpretation of the results&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; it is not easy to identify the factors related to the habit of alcohol consumption and complicated AWS&#46; However&#44; factors such as educational level and the consumption of other abused drugs could help identify patients with the risk of developing more severe forms of AWS&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">The database management was funded by the Alcohol and Alcoholism Workgroup of the Spanish Society of Internal Medicine&#46; The investigators received no remuneration for their participation in the study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Authors&#47;Collaborators</span><p id="par0120" class="elsevierStylePara elsevierViewall">Collaborating investigators&#58; L&#46; Garc&#237;a-Pere&#241;a &#40;University Hospital San Cecilio&#44; Granada&#41;&#44; F&#46; Epelde &#40;University Hospital Parc Tauli&#44; Sabadell&#41;&#44; R&#46; G&#243;mez-M&#233;ndez &#40;University Hospital Lucus Augusti&#44; Lugo&#41; and AJ Chamorro-Fern&#225;ndez &#40;University Hospital&#44; Salamanca&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interests</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "S&#237;ndrome de abstinencia alcoh&#243;lica"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome &#40;AWS&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A multicentre&#44; observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments&#46; We recorded sociodemographic&#44; epidemiological&#44; clinical and progression data&#46; Complicated AWS was defined as that which progressed with seizures or <span class="elsevierStyleItalic">delirium tremens</span>&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We studied 228 episodes of AWS in 219 patients&#46; The mean age was 54&#46;5 years &#40;SD&#44; 11&#46;5&#41;&#44; and 90&#46;8&#37; were men&#46; AWS was the cause for hospitalization in 39&#46;9&#37; of the patients&#46; Some 27&#46;1&#37; of the cases presented seizures&#44; and 32&#46;4&#37; presented <span class="elsevierStyleItalic">delirium tremens</span>&#46; The daily quantity of alcohol ingested was 17&#46;8 standard drink units &#40;SD&#44; 21&#46;4&#41;&#44; with 16&#46;6 years of dependence &#40;SD&#44; 11&#46;3&#41;&#46; The pattern of alcohol abuse was regular in 82&#46;8&#37; of the patients&#46; Some 38&#46;4&#37; of the patients were married or had a partner&#44; and 45&#46;6&#37; had children&#46; Some 72&#46;7&#37; of the patients were unemployed or retired&#46; Some 68&#46;5&#37; had only completed primary studies&#46; Some 4&#46;8&#37; consumed cannabis&#44; 5&#46;2&#37; consumed cocaine and 3&#37; consumed opioids&#46; The independent variables related to complicated AWS were consumption of a drug other than alcohol &#40;OR&#44; 5&#46;3&#59; 95&#37; CI 1&#46;5&#8211;18&#46;7&#41;&#44; low education level &#40;OR&#44; 3&#46;4&#59; 95&#37; CI 1&#46;6&#8211;7&#46;3&#41; and hospitalization for AWS &#40;OR&#44; 2&#46;9&#59; 95&#37; CI 1&#46;5&#8211;5&#46;6&#41;&#46; The model&#39;s receiver operating characteristic area was 0&#46;718 &#40;95&#37; CI 0&#46;643&#8211;0&#46;793&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Concomitant drug abuse and a low educational level could help identify patients at risk of complicated AWS&#46;</p></span>"
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            "titulo" => "Material and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la influencia de los factores epidemiol&#243;gicos y sociodemogr&#225;ficos en el s&#237;ndrome de abstinencia alcoh&#243;lica &#40;SAA&#41; complicado&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio multic&#233;ntrico&#44; observacional&#44; prospectivo de enfermos consecutivos con SAA ingresados en servicios de Medicina Interna&#46; Se registraron datos sociodemogr&#225;ficos&#44; epidemiol&#243;gicos&#44; cl&#237;nicos y evolutivos&#46; Se defini&#243; SAA complicado como aquel que hab&#237;a cursado con convulsiones o <span class="elsevierStyleItalic">delirium tremens</span>&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 228 episodios de SAA en 219 pacientes&#46; La edad media fue de 54&#44;5 a&#241;os &#40;DE 11&#44;5&#41;&#44; y el 90&#44;8&#37; fueron hombres&#46; El SAA fue la causa de ingreso en el 39&#44;9&#37;&#46; El 27&#44;1&#37; de los casos presentaron crisis comiciales y el 32&#44;4&#37; <span class="elsevierStyleItalic">delirium tremens</span>&#46; La cantidad ingerida de alcohol diaria fue 17&#44;8 unidades de bebida est&#225;ndar &#40;DE 21&#44;4&#41;&#44; con 16&#44;6 a&#241;os de dependencia &#40;DE 11&#44;3&#41;&#46; El patr&#243;n de abuso de alcohol fue regular en el 82&#44;8&#37;&#46; Viv&#237;an casados o en pareja el 38&#44;4&#37; y el 45&#44;6&#37; ten&#237;a hijos&#46; Un 72&#44;7&#37; estaba en paro o era pensionista&#46; El 68&#44;5&#37; solo hab&#237;an cursado estudios primarios&#46; El 4&#44;8&#37; consum&#237;a cannabis&#44; 5&#44;2&#37; coca&#237;na y 3&#37; opi&#225;ceos&#46; Las variables independientes relacionadas con SAA complicado fueron&#58; consumo de alguna droga diferente del alcohol &#40;OR 5&#44;3&#59; IC 95&#37; 1&#44;5-18&#44;7&#41;&#44; bajo nivel de estudios &#40;OR 3&#44;4&#59; IC 95&#37; 1&#44;6-7&#44;3&#41; y el ingreso por SAA &#40;OR 2&#44;9&#59; IC 95&#37; 1&#44;5-5&#44;6&#41;&#46; El &#225;rea ROC del modelo fue de 0&#44;718 &#40;IC 95&#37; 0&#44;643-0&#44;793&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El consumo concomitante de otras drogas de abuso y el nivel bajo de estudios pueden ayudar en la identificaci&#243;n de pacientes con riesgo de SAA complicado&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Monte-Secades R&#44; Blanco-Soto M&#44; D&#237;az-Peromingo JA&#44; Sanvisens-Berg&#233; A&#44; Mart&#237;n-Gonz&#225;lez MC&#44; Barbosa A&#44; et al&#46; Factores epidemiol&#243;gicos y sociodemogr&#225;ficos asociados al s&#237;ndrome de abstinencia alcoh&#243;lica complicado&#46; Rev Clin Esp&#46; 2017&#59;217&#58;381&#8211;386&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; CI&#44; confidence interval&#59; RR&#44; relative risk&#59; AWS&#44; alcohol withdrawal syndrome&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">AWS&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">Complicated AWS&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="middle" scope="col" style="border-bottom: 2px solid black">RR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Years of alcohol consumption&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">28&#46;8 &#40;14&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">28&#46;7 &#40;12&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Years of alcohol dependence<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">16&#46;9 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">16&#46;4 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Grams of alcohol daily<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">153&#46;9 &#40;100&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">190&#46;7 &#40;135&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Standard beverage units&#47;day<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">15&#46;6 &#40;23&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">20&#46;3 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">No&#46; of attempts at detoxification<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;6 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">No&#46; of previous AWS<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;5 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#46;4 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">No&#46; of emergency department visits<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;5 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Intake of spirits&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">44 &#40;37&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">34 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;7 &#40;0&#46;4&#8211;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Regular intake pattern&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">100 &#40;52&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">89 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;8 &#40;0&#46;5&#8211;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Smoker&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">79 &#40;66&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">71 &#40;64&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;8 &#40;0&#46;4&#8211;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Cannabis consumption&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">4 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">7 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#46;8 &#40;0&#46;5&#8211;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Cocaine consumption&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">10 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">5&#46;3 &#40;1&#46;1&#8211;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Opioid consumption&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">5 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2&#46;5 &#40;0&#46;4&#8211;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Use of synthetic drugs&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&#46;5 &#40;0&#46;4&#8211;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Drug abuse other than alcohol&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">4 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">15 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">4 &#40;1&#46;3&#8211;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Charlson index<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&#46;9 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2&#46;1 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">Hospitalization for AWS&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">31 &#40;26&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">60 &#40;54&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">3&#46;3 &#40;1&#46;9&#8211;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; CI&#44; confidence interval&#59; RR&#44; relative risk&#59; AWS&#44; alcohol withdrawal syndrome&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AWS&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complicated AWS&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&#44; years &#40;SD&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;2 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;6 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109 &#40;92&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;89&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4 &#40;0&#46;5&#8211;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospital &#62;500 beds&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83 &#40;70&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;62&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7 &#40;0&#46;4&#8211;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Population &#60;10&#44;000 inhabs&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;34&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;13&nbsp;\t\t\t\t\t\t\n
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              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Global status report on alcohol and health-2014 ed&#46;"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2014"
                        "editorial" => "World Health Organization"
                        "editorialLocalizacion" => "Luxembourg"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and routine assessment of unhealthy alcohol use in hospitalized patients"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ASMI Study Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Ros&#243;n"
                            1 => "R&#46; Monte"
                            2 => "R&#46; Gamallo"
                            3 => "R&#46; Puerta"
                            4 => "A&#46; Zapatero"
                            5 => "J&#46; Fern&#225;ndez-Sol&#225;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejim.2010.04.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Intern Med"
                        "fecha" => "2010"
                        "volumen" => "21"
                        "paginaInicial" => "458"
                        "paginaFinal" => "464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20816605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genome-wide association study of alcohol dependence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Treutlein"
                            1 => "S&#46; Cichon"
                            2 => "M&#46; Ridinger"
                            3 => "N&#46; Wodarz"
                            4 => "M&#46; Soyka"
                            5 => "P&#46; Zill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archgenpsychiatry.2009.83"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Gen Psychiatry"
                        "fecha" => "2009"
                        "volumen" => "66"
                        "paginaInicial" => "773"
                        "paginaFinal" => "784"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19581569"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for delirium tremens in patients with alcohol withdrawal syndrome in a hospital setting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Monte"
                            1 => "R&#46; Rabu&#241;al"
                            2 => "E&#46; Casariego"
                            3 => "M&#46; Bal"
                            4 => "S&#46; P&#233;rtega"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejim.2009.07.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Intern Med"
                        "fecha" => "2009"
                        "volumen" => "20"
                        "paginaInicial" => "690"
                        "paginaFinal" => "694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19818288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of severe alcohol withdrawal syndrome&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;M&#46; Goodson"
                            1 => "B&#46;J&#46; Clark"
                            2 => "I&#46;S&#46; Douglas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/acer.12529"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2014"
                        "volumen" => "38"
                        "paginaInicial" => "2664"
                        "paginaFinal" => "2677"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25346507"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Social and clinical features as predictors of outcome in outpatient alcohol withdrawal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;G&#46; O&#8217;Connor"
                            1 => "L&#46;D&#46; Gottlieb"
                            2 => "M&#46;L&#46; Kraus"
                            3 => "S&#46;R&#46; Segal"
                            4 => "R&#46;I&#46; Horwitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gen Intern Med"
                        "fecha" => "1991"
                        "volumen" => "6"
                        "paginaInicial" => "312"
                        "paginaFinal" => "316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1890501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Predictionof Alcohol Withdrawal Severity Scale &#40;PAWSS&#41;&#58; systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "J&#46;F&#46; Ashouri"
                            3 => "K&#46; Hills-Evans"
                            4 => "H&#46; Swendsen"
                            5 => "S&#46; Lolak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Alcohol"
                        "fecha" => "2014"
                        "volumen" => "48"
                        "paginaInicial" => "375"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24657098"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of drinking and functional outcomes for men and women following inpatient alcohol treatment"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;E&#46; Sugarman"
                            1 => "J&#46;S&#46; Kaufman"
                            2 => "E&#46;M&#46; Trucco"
                            3 => "J&#46;C&#46; Brown"
                            4 => "S&#46;F&#46; Greenfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1521-0391.2014.12098.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Addict"
                        "fecha" => "2014"
                        "volumen" => "23"
                        "paginaInicial" => "226"
                        "paginaFinal" => "233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24724879"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis and statistical manual of mental disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "American Psychiatric Association"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "4th ed&#46; rev&#46;"
                        "fecha" => "2000"
                        "editorial" => "American Psychiatric Association"
                        "editorialLocalizacion" => "Washington&#44; DC"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Encuesta Nacional de S&#46; Serie informes monogr&#225;ficos n&#46;&#176;1&#46; Consumo de alcohol"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2013"
                        "editorial" => "Ministerio de Sanidad&#44; Servicios sociales e Igualdad"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "EDADES 2011&#47;12&#46; Delegaci&#243;n del Gobierno para el Plan Nacional sobre Drogas"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2013"
                        "editorial" => "Ministerio de Sanidad&#44; Servicios Sociales e Igualdad"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0060"
              "etiqueta" => "12"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Encuesta Europea de Salud en Espa&#241;a 2014"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2015"
                        "editorial" => "Instituto Nacional de Estad&#237;stica&#47;Ministerio de Sanidad&#44; Servicios Sociales e Igualdad"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal and spatial patterns in the rate of alcohol withdrawal syndrome in a defined community"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Gonzalez-Quintela"
                            1 => "S&#46; Fern&#225;ndez-Conde"
                            2 => "M&#46;T&#46; Alves"
                            3 => "J&#46; Campos"
                            4 => "M&#46; Lopez-Raton"
                            5 => "R&#46; Puerta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.alcohol.2010.08.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol"
                        "fecha" => "2011"
                        "volumen" => "45"
                        "paginaInicial" => "105"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20843642"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
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                          "autores" => array:2 [
                            0 => "L&#46; Ng Fat"
                            1 => "E&#46; Fuller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "fecha" => "2012"
                        "paginaInicial" => "207"
                        "paginaFinal" => "252"
                        "editorial" => "The Health and Social Care Information Centre"
                      ]
                    ]
                  ]
                ]
              ]
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            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Liver disease in heavy drinkers with and without alcohol withdrawal syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Barrio"
                            1 => "S&#46; Tom&#233;"
                            2 => "I&#46; Rodr&#237;guez"
                            3 => "F&#46; Gude"
                            4 => "J&#46; S&#225;nchez-Leira"
                            5 => "E&#46; P&#233;rez-Becerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.ALC.0000106301.39746.EB"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2004"
                        "volumen" => "28"
                        "paginaInicial" => "131"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14745311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of alcohol consumption by mailed questionnaire in epidemiological studies&#58; evaluation of misclassification using a dietary history interview and biochemical markers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Carlsson"
                            1 => "N&#46; Hammar"
                            2 => "P&#46; Hakala"
                            3 => "J&#46; Kaprio"
                            4 => "J&#46; Marniemi"
                            5 => "T&#46; R&#246;nnemaa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Epidemiol"
                        "fecha" => "2003"
                        "volumen" => "18"
                        "paginaInicial" => "493"
                        "paginaFinal" => "501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12908714"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action &#8216;Gender&#44; Culture and Alcohol Problems&#58; a Multi-national Study&#8217;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Bloomfield"
                            1 => "U&#46; Grittner"
                            2 => "S&#46; Kramer"
                            3 => "G&#46; Gmel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/alcalc/agl073"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Alcohol Suppl"
                        "fecha" => "2006"
                        "volumen" => "41"
                        "paginaInicial" => "i26"
                        "paginaFinal" => "i36"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17030500"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends and determinants of alcohol consumption in Portugal&#58; results from the national health surveys 1995 to 1996 and 1998 to 1999"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Marques-Vidal"
                            1 => "C&#46;M&#46; Dias"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "89"
                        "paginaFinal" => "97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15654297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multiple admissions for alcohol withdrawal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; Larson"
                            1 => "M&#46;C&#46; Burton"
                            2 => "D&#46;T&#46; Kashiwagi"
                            3 => "Z&#46;P&#46; Hugo"
                            4 => "S&#46;S&#46; Cha"
                            5 => "M&#46;I&#46; Lapid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jhm.1953"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hosp Med"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "617"
                        "paginaFinal" => "621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22791681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The detoxification experience of alcoholic in-patients and predictors of outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;K&#46; Shaw"
                            1 => "S&#46; Waller"
                            2 => "C&#46;J&#46; Latham"
                            3 => "G&#46; Dunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Alcohol"
                        "fecha" => "1998"
                        "volumen" => "33"
                        "paginaInicial" => "291"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9632055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Social factors but not stress-coping styles predict relapse in detoxified alcoholics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Walter"
                            1 => "U&#46; Gerhard"
                            2 => "K&#46;M&#46; Duersteler-MacFarland"
                            3 => "H&#46;G&#46; Weijers"
                            4 => "J&#46; Boening"
                            5 => "G&#46;A&#46; Wiesbeck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000096991"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuropsychobiology"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "100"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17108710"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unemployment and substance outcomes in the United States 2002&#8211;2010"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;M&#46; Compton"
                            1 => "J&#46; Gfroerer"
                            2 => "K&#46;P&#46; Conway"
                            3 => "M&#46;S&#46; Finger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.drugalcdep.2014.06.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Alcohol Depend"
                        "fecha" => "2014"
                        "volumen" => "142"
                        "paginaInicial" => "350"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25042761"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manifestaciones y curso cl&#237;nico del s&#237;ndrome de abstinencia alcoh&#243;lica en un hospital general"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Monte Secades"
                            1 => "E&#46; Casariego Vales"
                            2 => "S&#46; P&#233;rtega D&#237;az"
                            3 => "R&#46; Rabu&#241;al Rey"
                            4 => "M&#46; Pe&#241;a Zemsch"
                            5 => "S&#46; Pita Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2008"
                        "volumen" => "208"
                        "paginaInicial" => "506"
                        "paginaFinal" => "512"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19100132"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence&#44; clinical characteristics&#44; and risk factors for non-recording of alcohol use in hospitals across Europe&#58; The ALCHIMIE Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Ros&#243;n"
                            1 => "X&#46; Corbella"
                            2 => "P&#46; Perney"
                            3 => "A&#46; Santos"
                            4 => "R&#46; Stauber"
                            5 => "M&#46; Lember"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/alcalc/agv142"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Alcohol"
                        "fecha" => "2016"
                        "volumen" => "51"
                        "paginaInicial" => "457"
                        "paginaFinal" => "464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26818195"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pharmacological management of alcohol withdrawal&#46; A meta-analysis and evidence-based practice guideline"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal"
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;F&#46; Mayo-Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1997"
                        "volumen" => "278"
                        "paginaInicial" => "144"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9214531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective validation study of the prediction of alcohol withdrawal severity scale &#40;PAWSS&#41; in medically ill inpatients&#58; a new scale for the Prediction of Complicated Alcohol Withdrawal Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;R&#46; Maldonado"
                            1 => "Y&#46; Sher"
                            2 => "S&#46; Das"
                            3 => "K&#46; Hills-Evans"
                            4 => "A&#46; Frenklach"
                            5 => "S&#46; Lolak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/alcalc/agv043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Alcohol"
                        "fecha" => "2015"
                        "volumen" => "50"
                        "paginaInicial" => "509"
                        "paginaFinal" => "518"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25999438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The histories of withdrawal convulsions and delirium tremens in 1648 alcohol dependent subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;A&#46; Schuckit"
                            1 => "J&#46;E&#46; Tipp"
                            2 => "T&#46; Reich"
                            3 => "V&#46;M&#46; Hesselbrock"
                            4 => "K&#46;K&#46; Bucholz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Addiction"
                        "fecha" => "1995"
                        "volumen" => "90"
                        "paginaInicial" => "1335"
                        "paginaFinal" => "1347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8616462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concurrent cocaine withdrawal alters alcohol withdrawal symptoms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Kampman"
                            1 => "H&#46; Pettinati"
                            2 => "J&#46; Volpicelli"
                            3 => "G&#46; Kaempf"
                            4 => "E&#46; Turk"
                            5 => "A&#46; Insua"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1300/J069v21n04_02"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Addict Dis"
                        "fecha" => "2002"
                        "volumen" => "21"
                        "paginaInicial" => "13"
                        "paginaFinal" => "26"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12296498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol-related seizures and the kindling effect of repeated detoxifications&#58; the influence of cocaine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;H&#46; Moak"
                            1 => "R&#46;F&#46; Anton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Alcohol"
                        "fecha" => "1996"
                        "volumen" => "31"
                        "paginaInicial" => "135"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8737008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concurrent cocaine withdrawal is associated with reduced severity of alcohol withdrawal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Castaneda"
                            1 => "H&#46; Lifshutz"
                            2 => "L&#46; Westreich"
                            3 => "M&#46; Galanter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Compr Psychiatry"
                        "fecha" => "1995"
                        "volumen" => "36"
                        "paginaInicial" => "441"
                        "paginaFinal" => "447"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8565449"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol dependence among cocaine-dependent outpatients&#58; demographics&#44; drug use&#44; treatment outcome and other characteristics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;H&#46; Heil"
                            1 => "G&#46;J&#46; Badger"
                            2 => "S&#46;T&#46; Higgins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Stud Alcohol"
                        "fecha" => "2001"
                        "volumen" => "62"
                        "paginaInicial" => "14"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11271960"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
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Article information

ISSN: 22548874
Original language: English

DOI:10.1016/j.rceng.2017.05.003

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