Age and Sex Differences in Alcohol Withdrawal Syndrome.
Mayo Clin Proc Innov Qual Outcomes 2026 Jun; 10(3):100722.

Abstract

OBJECTIVE

To investigate alcohol withdrawal syndrome prevalence among women and to study age and sex differences in clinical manifestations and hospital course.

PATIENTS AND METHODS

This cohort study included all hospitalized patients from June 1, 2019 to June 1, 2022, where the Clinical Institute Withdrawal Assessment for Alcohol Scale, revised, protocol for alcohol withdrawal syndrome was implemented.

RESULTS

A total of 16,190 hospitalizations (10,092 patients aged ≥21 years), with 30.2% women, were included in the study and divided into the following 4 age groups: 21 to 39 years (n=2453 [24.3%]), 40-64 years (n=5128 [50.8%]), 65-74 years (n=1705 [16.9%]), and 75 years or older (n=806 [8%]). We considered the age group (40-64 years) with the highest number of patients as the reference group. Older patients presented with lower blood alcohol concentration and took longer to reach peak withdrawal manifestations than younger patients. Compared with women, men in the youngest age group reached a peak withdrawal earlier (mean, 18.5 hours [95% CI, 17.2-19.8] vs 19.4 hours [95% CI, 17.5-21.3]; P<.001), and there was no sex difference in other age groups. Men required higher benzodiazepine doses during hospitalization in the youngest (mean, 20.1 mg [95% CI, 17.1-23.1] vs 13.6 mg [95% CI, 11.4-15.8]; P=.013) and the reference (mean, 18.0 mg [95% CI, 16.5-19.4] vs 12.7 mg [95% CI, 11.4-14]; P<.001) age groups; there was no sex difference among older adults. The benzodiazepine dose during the first 24 hours of hospitalization dose decreased significantly as age increased (21-39 years: mean, 6.64 mg [95% CI, 6.3-7.0]; 40-64 years: mean, 5.8 mg [95% CI, 5.5-6.0]; 65-74 years: mean, 3.76 mg [95% CI, 3.4-4.1]; ≥75 years: mean, 2.79 mg [95% CI, 2.4-3.2]; P<.001 for all groups). There was no sex difference in the all-cause mortality rate, including posthospitalization mortality, among any age group.

CONCLUSION

The results of this study show a narrowing of the traditional sex gap in alcohol withdrawal.

Links

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Authors+Show Affiliations

Unlu HDepartment of Psychiatry and Psychology, Mayo Clinic, Phoenix, AZ. Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA.
Zhang NKern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Yehia ADepartment of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ. Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Isazade VDepartment of Psychiatry and Psychology, Mayo Clinic, Phoenix, AZ.
Jeffery MMKern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. Emergency Medicine, Mayo Clinic, Rochester, MN.
Abulseoud OADepartment of Psychiatry and Psychology, Mayo Clinic, Phoenix, AZ. Department of Neuroscience, Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine, Phoenix, AZ.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

42221909