Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

Calculator

When to use

Threshold criteria

Alcohol consumption in the last 30 days or a positive blood alcohol level on admission

Patient interview

Have been recently intoxicated or drunk in the last 30 days

Have experienced previous episodes of alcohol withdrawal

Have experienced withdrawal seizures

Have experienced delirium tremens

Have undergone alcohol rehabilitation treatment inpatient or outpatient treatment programs, or Alcoholics Anonymous attendance)

Have experienced blackouts

Have combined alcohol with other "downers" such as benzodiazepines or barbiturates) in the last 90 days

Have combined alcohol with any other substance of abuse in the last 90 days

Clinical evidence

Positive blood alcohol level on presentation

Evidence of increased autonomic activity heart rate > 120 bpm, tremor, sweating, agitation, nausea)

Calculation

Please enter all the required inputs.

The Prediction of Alcohol Withdrawal Severity Scale (PAWSS) is a clinical calculator used in the management of patients with alcohol use disorder. It is specifically designed to predict the risk and severity of alcohol withdrawal syndrome in adults who are admitted to the hospital for reasons other than alcohol withdrawal. The PAWSS is clinically useful in identifying patients who are at risk of developing severe alcohol withdrawal symptoms, including seizures and delirium tremens. This allows for early intervention and management, potentially reducing morbidity and mortality associated with severe alcohol withdrawal. The PAWSS is not intended for use in patients under the age of 18, or in patients who are admitted to the hospital specifically for alcohol withdrawal. It also may not be as accurate in patients with severe comorbid conditions or those who are unable to provide a reliable history of their alcohol use.

Reference

José R Maldonado, Yelizaveta Sher, Judith F Ashouri 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. 2014 Jun;48(4):375-90.

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