Original article / research
Thrombocytopaenia in Alcohol Withdrawal: A Retrospective Study on its Prevalence and Role as a Low-cost Predictor of Delirium Tremens
VC01-VC04
Correspondence
Vijeyta Naresh,
C-7/5, Akila Heights Apartment, Tambaram-Velachery Main Road, Sembakkam, Chennai-600073, Tamil Nadu, India.
E-mail: drvijeytanaresh@gmail.com
Introduction: Delirium Tremens (DT) is a life-threatening alcohol withdrawal complication, requiring early identification to improve outcomes. Alcohol-induced Thrombocytopaenia (TP) may serve as a cost-effective predictor of DT. Although several biochemical markers have been studied for predicting DT, reliable, simple and cost-effective early predictors remain limited, especially in resource-limited settings. Since platelet count is routinely available and inexpensive, evaluating TP as a potential predictor of DT may provide a practical tool for early risk stratification.
Aim: To study the prevalence of TP in alcohol withdrawal and its predictive role in DT.
Materials and Methods: The present retrospective observational study reviewed case records of adult patients (≥18 years) admitted with an International Classification of Disease-10 (ICD-10) diagnosis of alcohol withdrawal between September 2022 and March 2025 at the Department of Psychiatry, Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India. Only records with platelet counts available at admission were included, yielding a total sample of 409 patients. Data on demographic characteristics, along with relevant clinical and laboratory findings, were collected. The prevalence of TP and its predictive value for DTs were evaluated using sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Statistical associations were determined using appropriate tests and multiple logistic regression with a significance level set at p<0.05.
Results: The prevalence of TP was 93 patients (22.7%). DT incidence was 12.5% (51 patients). DT occurred in 39.8% of thrombocytopenic patients, showing a strong association (p<0.001). Regression analysis identified previous history of DT and TP as strong predictors of DT. TP demonstrated 72.5% sensitivity, 84.4% specificity, moderate PPV (39.8%) and high NPV (95.6%).
Conclusion: The TP is a cost-effective, highly specific predictor of DT in Alcohol Withdrawal Syndrome (AWS), making it useful for risk stratification in resource-limited settings. Further research is needed to evaluate its clinical utility.