TY - JOUR
T1 - Prevalence of Patients Admitted to Intensive Care After Administration of Chlordiazepoxide in the Emergency Room
AU - Henriksen, Jakob Nørgaard
AU - Rosenquist, Sara Buttrup
AU - Illum, Dorte Goldbækdal
AU - Andersen, Charlotte Uggerhøj
PY - 2025/4
Y1 - 2025/4
N2 - Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.
AB - Chlordiazepoxide is effective in treating alcohol withdrawal syndrome, but it poses a risk of long-term sedation. The prevalence of this side effect and its risk factors remain uncertain. This retrospective cross-sectional study aimed to estimate both using data from Aarhus University Hospital's BI portal. We identified and manually reviewed patient records from 1 September 2019 to 31 August 2021, including the treating physicians' conclusions on ICU admissions to determine whether they were likely due to chlordiazepoxide toxicity. Chlordiazepoxide was administered to 1363 unique patients in the study period. We identified 32 ICU admissions preceded by chlordiazepoxide administration, 5 of which (16%) were likely related to chlordiazepoxide toxicity. Patients with chlordiazepoxide-induced admissions received higher cumulative doses compared to other admissions (425 mg vs. 150 mg, p = 0.01), had longer ICU stays (median 8 vs. 2 days, p = 0.01) and required higher doses of flumazenil (p = 0.04). Their median age was above 60 years, and not all had known liver disease. The overall incidence of long-term chlordiazepoxide toxicity was approximately 0.35%, with risk factors including higher doses and age above 60. Our findings suggest increased caution when treating not only patients with liver disease but also elderly patients with chlordiazepoxide for alcohol withdrawal symptoms.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Chlordiazepoxide/administration & dosage
KW - Critical Care/methods
KW - Cross-Sectional Studies
KW - Emergency Service, Hospital/statistics & numerical data
KW - Female
KW - Flumazenil/therapeutic use
KW - Humans
KW - Hypnotics and Sedatives/adverse effects
KW - Intensive Care Units/statistics & numerical data
KW - Length of Stay
KW - Male
KW - Middle Aged
KW - Patient Admission/statistics & numerical data
KW - Prevalence
KW - Retrospective Studies
KW - Risk Factors
KW - Substance Withdrawal Syndrome/epidemiology
KW - chlordiazepoxide
KW - alcoholism
KW - poisoning
KW - abstinence
KW - liver cirrhosis
UR - http://www.scopus.com/inward/record.url?scp=105000109958&partnerID=8YFLogxK
U2 - 10.1111/bcpt.70018
DO - 10.1111/bcpt.70018
M3 - Journal article
C2 - 40070362
SN - 1742-7843
VL - 136
JO - Basic & Clinical Pharmacology & Toxicology
JF - Basic & Clinical Pharmacology & Toxicology
IS - 4
M1 - e70018
ER -