The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS)

• Moderate to severe alcohol withdrawal [ Time Frame: During the first 72 hours after admission. ] [ Designated as safety issue: Yes ]
  

• Amount of benzodiazepines administered [ Time Frame: During the first 72 hours after admission. ] [ Designated as safety issue: No ]
  
• Development of delirium tremens (DT's) [ Time Frame: During the first 72 hours after admission. ] [ Designated as safety issue: Yes ]
  
• Development of seizures (in absence of underlying seizure disorder) [ Time Frame: During the first 72 hours after admission. ] [ Designated as safety issue: Yes ]
  
• Transfer to ICU due to severe AWS [ Time Frame: During the first 5 days after admission. ] [ Designated as safety issue: No ]
  
• Development of delirium [ Time Frame: During the first 72 hours after admission. ] [ Designated as safety issue: Yes ]
  
• Length of hospital stay [ Time Frame: Participants will be followed for the duration of hospital stay, an expected average of 7 days. ] [ Designated as safety issue: Yes ]
  

The investigators plan to study the psychometric properties of a new tool, the "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS) on predicting the risk for the development of moderate to severe AWS in hospitalized medical patients. This tool was developed through an extensive literature review which identified evidence-based predictors for AWS.

The scale consists of three portions relating to 1) an initial screening (threshold items), 2) patient's history of alcohol use and its consequences, and 3) measures of BAL and autonomic function. The investigators predict that a scale score 3 or greater will be associated with a high risk for the development of moderate to severe AWS.

Patients will be undergo examination with the PAWSS within 24 hours of admission. Thereafter, all patients will undergo daily examinations with the Clinical Institute Withdrawal Assessment (CIWA) and Alcohol Withdrawal Severity scale (AWSS) in order to measure the primary outcomes of the study, that is, the development and severity (i.e., moderate to severe) of AWS during the first 72-hours after admission. The study is designed to study the SIPAT-tool's psychometirc properties including its validity and inter-rater reliability.

By providing clinicians with a tool (i.e., PAWSS) that allows them to correctly predict who will develop moderate-severe AWS it will enable them to prophylax (i.e., preventively treat) patients at risk and thus decrease patients' morbidity and mortality, length of hospital stay, and minimize the significant burden on the nursing and medical staff.