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Correlation Between mMINDS and CIWA-Ar Scoring Tools in Patients With Alcohol Withdrawal Syndrome
Audrey J Littlefield1, Mojdeh S Heavner2, Claire C Eng2
1Audrey J. Littlefield is clinical pharmacy manager, cardiothoracic intensive care unit, Department of Pharmacy, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York. Mojdeh S. Heavner is assistant professor of critical care, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, Maryland. Claire C. Eng is clinical pharmacy specialist, critical care, Department of Pharmacy, Memorial Hermann Katy Hospital, Katy, Texas. Dawn A. Cooper is service line educator and Jeanette M. Kurtz is assistant patient service manager, medical intensive care unit and step-down unit, Department of Nursing, Yale New Haven Hospital, New Haven, Connecticut. Jason J. Heavner is chair, Section of Critical Care, University of Maryland Baltimore Washington Medical Center, Glen Burnie, Maryland. Margaret A. Pisani is associate professor and director of the Pulmonary and Critical Care Fellowship Program, Yale University School of Medicine, New Haven, Connecticut. ajl9010@nyp.org.
Background:
Many alcohol withdrawal scoring tools are used in hospitalized patients to assess the severity of alcohol withdrawal and guide treatment. The revised Clinical Institute Withdrawal Assessment (CIWA-Ar) and the modified Minnesota Detoxification Scale (mMINDS) are commonly used but have never been correlated.
Objective:
To determine the strength of correlation between the CIWA-Ar and mMINDS scoring tools in patients with alcohol withdrawal syndrome.
Methods:
A single-center, prospective correlation study conducted at a large academic medical center. Patients treated for alcohol withdrawal syndrome according to the Yale Alcohol Withdrawal Protocol were identified daily, and both the CIWA-Ar and mMINDS were administered at each time point required by the protocol. Clinical data were obtained from the electronic medical records.
Results:
A total of 185 CIWA-Ar and mMINDS scores were collected in 30 patients. The Pearson correlation coefficient across all scores was 0.82, indicating a strong correlation. The Pearson correlation coefficient was 0.87 for CIWA-Ar scores of 10 or less and 0.52 for CIWA-Ar scores above 10. Strong correlations were also shown for tremor (0.98), agitation (0.84), and orientation (0.87).
Conclusions:
The correlation between the CIWA-Ar and mMINDS tools is strong and appears to be most robust in patients with CIWA-Ar scores of 10 or less.
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