This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Clinical Institute Withdrawal Assessment for Alcohol (CIWA -A) scale

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A) scale is a useful tool to assess severity of AWS (1)

  • the scale is not a diagnostic tool as it has not been found to be useful in differentiating between DT and delirium due to medical illnesses (2)
  • scale includes 10 common signs and symptoms of alcohol withdrawal with the notable exceptions of pulse rate and blood pressure, which must be a part of the assessment of alcohol withdrawal states
  • the 10-item revised form (CIWA-Ar) is described
  • CIWA-Ar scale requires limited patient cooperation to evaluate its ten symptoms

 

  • Score grading:
    • less than 8 indicate mild withdrawal,
    • 8–15 indicate moderate withdrawal (marked autonomic arousal)
    • and >15 indicate severe withdrawal and are also predictive of the development of seizures and delirium
  • Score interpretation:
    • if CIWA-Ar score is <8 pharmacological treatment is not necessary
    • if CIWA-Ar score 8-15 pharmacological treatment may be appropriate to prevent the progression to more severe forms of AWS
    • pharmacological treatment is strongly indicated in patients with CIWA-Ar score >15

The evaluation of CIWA-Ar score should be repeated at least every 8 hours. In patients with scores >8–10 or requiring treatment, CIWA should be repeated every hour to evaluate the response to treatments

Reference:

  • Mirijello A et al. Identification and Management of Alcohol Withdrawal Syndrome Drugs. 2015 Mar; 75(4): 353–365.
  • Kattimani S, Bharadwaj B.Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013 Jul-Dec; 22(2): 100–108.

Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.