Clinical assessment and risk stratification
Screening for AUD
The key to minimising the impact of AWS on the patient is early identification of the fact that the patient is at risk. NICE9 and the RCEM10 suggests that patients should be screened for AUD using questionnaire style assessment tools such as the Alcohol Use Disorder Identification Test (AUDIT) or Fast Alcohol Assessment Tool (FAST)
Focused Alcohol Screening Tool (FAST)
These screening tools only identify AUD and do not predict likelihood or severity of AWS. Several screening tools have been developed which attempt to quantify risk of AWS11,12,13,14,15 though none of these is in current widespread use. The Glasgow Modified Alcohol Withdrawal Scale (GMAWS) protocol classifies patients with AUD plus at least one of the following as high risk of complicated AWS16
- High FAST score (>12) at presentation
- Previous severe withdrawal or alcohol related seizure
- Severe symptoms of AWS at presentation