A new study from South Korea identified 3 potential clinical predictors of developing delirium tremens in patients presenting to the ED with alcohol withdrawal seizures.
Low platelet count
High blood level of homocysteine
Low blood level of pyridoxine
If one or more is present, these findings may help assess alcohol withdrawal patients for the risk of developing DTs.
Application to Clinical Practice
The problem is that in the U.S., homocysteine and pyridoxine levels may not be readily available at all institutions.
Adjunctive treatment options including vitamin B12, folate, and pyridoxine may be considered if levels are available, but it is unknown if 'treating the numbers' actually prevents development of DTs.
At the very least, these clinical predictors may help risk assess patients for appropriate disposition.
References
Kim DW, et al. Clinical predictors for delirium tremens in patients with alcohol withdrawal seizures. Am J Emerg Med 2015 Feb 23. [Epub ahead of print, PMID 25745798]
Follow me on Twitter (@PharmERToxGuy) or Google Plus (+bryanhayes13)
