Delirium tremens patients have increased mortality and morbidity compared to alcohol withdrawal or dependence

Norway: People treated for delirium tremens (DT), a severe alcohol withdrawal syndrome, appears to have higher comorbidity and mortality rates compared to people with other alcohol use disorders, a recent study published in Wiley Addiction has revealed. 

The national longitudinal health registry study aimed to compare outcomes including all-cause and cause-specific mortality, as well as alcohol-related morbidity, among patients with DT, alcohol withdrawal state (AWS), and alcohol dependence (AD). The study included 36,287 patients registered in the Norwegian Patient Registry between 2009 and 2015, aged 20 to 79 years, who had been diagnosed with AD, AWS, or DT.

● The findings of the study revealed that patients diagnosed with delirium tremens experienced a higher annual mortality rate of 8.0%, compared to 5.0% for those with AWS and 3.6% for those with alcohol dependence.

● The standardized mortality ratio (SMR) for DT patients was notably elevated at 9.8 (95% confidence interval [CI] = 8.9–10.7), indicating significantly higher mortality compared to AD patients (SMR = 7.0, 95% CI = 6.8–7.2) and AWS patients (SMR = 7.8, 95% CI = 7.2–8.4).

● The study's focus on cause-specific mortality revealed that unnatural causes of death were particularly elevated among DT patients, with an SMR of 26.9 (95% CI = 21.7–33.4), compared to 15.2 (95% CI = 14.2–16.3) for AD patients and 20.1 (95% CI = 16.9–23.9) for AWS patients.

● The study observed a higher proportion of comorbidities among DT patients compared to those with AWS or AD (P < 0.001).

These findings underscore the serious health risks associated with delirium tremens, indicating higher rates of both mortality and comorbidity compared to other alcohol use disorders. The study provides valuable insights into the long-term impact of DT and highlights the need for comprehensive care and support for individuals dealing with severe alcohol withdrawal.

Reference:

Bramness, J. G., Heiberg, I. H., Høye, A., & Rossow, I. (2023). Mortality and alcohol‐related morbidity in patients with delirium tremens, alcohol withdrawal state or alcohol dependence in Norway: A register‐based prospective cohort study. Addiction (Abingdon, England). https://doi.org/10.1111/add.16297