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Psychiatry · Internal Medicine

Prediction of Alcohol Withdrawal Severity Scale calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

mg/dL

Allowed range: 0–800 mg/dL

Quick picks

A level above 0 counts as a positive admission level and opens the screen, which adds 1 point. A level strictly above 200 mg/dL adds one further point. 200 mg/dL does not add that further point. The conversion from mmol/L uses 4.607.

Result

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Clinical inputs

  • Any alcohol in the last 30 days
  • Admission blood alcohol level (mg/dL)Accepted range: 0 to 800
  • Earlier episode of alcohol withdrawal
  • Earlier alcohol-withdrawal seizure
  • Earlier delirium tremens
  • Earlier alcohol rehabilitation, including mutual-help groups
  • Earlier blackouts
  • Alcohol combined with a benzodiazepine or a barbiturate in the last 90 days
  • Alcohol combined with any other substance of misuse in the last 90 days
  • Increased autonomic activity

Primary source

Maldonado JR 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. DOI: 10.1016/j.alcohol.2014.01.004. PMID: 24657098. Figure 2 labels the alcohol screen as 1 point for either alcohol in the last 30 days or a positive admission blood alcohol level, then seven interview items and two clinical items. The figure maximum is 10. High risk is 4 or more. In the pilot, 0 of 13 patients at or below 3, and 4 of 4 patients at or above 4, developed complicated withdrawal. A blood alcohol level of 200 mg/dL does not score the separate >200 item. (2014)

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