cliot (version 1.0.0)

pawss_score: Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

Description

Calculates the PAWSS score to screen hospitalized patients for the risk of developing complicated alcohol withdrawal syndrome (AWS), specifically seizures or delirium tremens. The scale consists of 10 items (Threshold criteria, Patient interview, and Clinical evidence), each worth 1 point.

Usage

pawss_score(recent_alcohol_use, bal_gt_200, previous_withdrawal,
            previous_seizures, previous_dts, previous_rehab, blackouts,
            concurrent_downer_use, concurrent_other_substance_use,
            autonomic_hyperactivity)

Value

A list containing:

PAWSS_Score

The calculated total score (Range 0-10).

Risk_Category

Classification (Low Risk < 4, High Risk >= 4).

Recommendation

Clinical guidance regarding prophylaxis and monitoring.

Arguments

recent_alcohol_use

Numeric (0 or 1). Has the patient consumed alcohol within the last 30 days OR was the patient intoxicated at presentation? (1 = Yes).

bal_gt_200

Numeric (0 or 1). Is the blood alcohol level (BAL) > 200 mg/dL? (1 = Yes).

previous_withdrawal

Numeric (0 or 1). Has the patient experienced prior episodes of alcohol withdrawal? (1 = Yes).

previous_seizures

Numeric (0 or 1). Has the patient experienced prior withdrawal seizures? (1 = Yes).

previous_dts

Numeric (0 or 1). Has the patient experienced prior delirium tremens (DTs)? (1 = Yes).

previous_rehab

Numeric (0 or 1). Has the patient undergone previous alcohol rehabilitation treatment? (1 = Yes).

blackouts

Numeric (0 or 1). Has the patient experienced blackouts? (1 = Yes).

concurrent_downer_use

Numeric (0 or 1). Has the patient combined alcohol with benzodiazepines or barbiturates in the last 90 days? (1 = Yes).

concurrent_other_substance_use

Numeric (0 or 1). Has the patient combined alcohol with any other substance of abuse in the last 90 days? (1 = Yes).

autonomic_hyperactivity

Numeric (0 or 1). Is there clinical evidence of increased autonomic activity (e.g., HR > 120 bpm, tremor, sweating, agitation, nausea)? (1 = Yes).

References

Maldonado JR, Sher Y, Ashouri JF, et al. The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome. Alcohol. 2014;48(4):375-390. doi:10.1016/j.alcohol.2014.01.004

Examples

# Example 1: High Risk (Score >= 4)
# Recent use, Hx of Seizures, Hx of DTs, Autonomic signs
pawss_score(1, 0, 1, 1, 1, 0, 0, 0, 0, 1)

# Example 2: Low Risk (Score < 4)
# Recent use, Hx of Rehab, Blackouts
pawss_score(1, 0, 0, 0, 0, 1, 1, 0, 0, 0)