pawss_score: Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

In cliot: Clinical Indices and Outcomes Tools

Prediction of Alcohol Withdrawal Severity Scale (PAWSS)

Description

Calculates the PAWSS score to screen hospitalized patients for the risk of developing complicated alcohol withdrawal syndrome (AWS), specifically seizures or delirium tremens. The scale consists of 10 items (Threshold criteria, Patient interview, and Clinical evidence), each worth 1 point.

Usage

pawss_score(recent_alcohol_use, bal_gt_200, previous_withdrawal,
            previous_seizures, previous_dts, previous_rehab, blackouts,
            concurrent_downer_use, concurrent_other_substance_use,
            autonomic_hyperactivity)

Arguments

recent_alcohol_use	Numeric (0 or 1). Has the patient consumed alcohol within the last 30 days OR was the patient intoxicated at presentation? (1 = Yes).
bal_gt_200	Numeric (0 or 1). Is the blood alcohol level (BAL) > 200 mg/dL? (1 = Yes).
previous_withdrawal	Numeric (0 or 1). Has the patient experienced prior episodes of alcohol withdrawal? (1 = Yes).
previous_seizures	Numeric (0 or 1). Has the patient experienced prior withdrawal seizures? (1 = Yes).
previous_dts	Numeric (0 or 1). Has the patient experienced prior delirium tremens (DTs)? (1 = Yes).
previous_rehab	Numeric (0 or 1). Has the patient undergone previous alcohol rehabilitation treatment? (1 = Yes).
blackouts	Numeric (0 or 1). Has the patient experienced blackouts? (1 = Yes).
concurrent_downer_use	Numeric (0 or 1). Has the patient combined alcohol with benzodiazepines or barbiturates in the last 90 days? (1 = Yes).
concurrent_other_substance_use	Numeric (0 or 1). Has the patient combined alcohol with any other substance of abuse in the last 90 days? (1 = Yes).
autonomic_hyperactivity	Numeric (0 or 1). Is there clinical evidence of increased autonomic activity (e.g., HR > 120 bpm, tremor, sweating, agitation, nausea)? (1 = Yes).

Value

A list containing:

PAWSS_Score	The calculated total score (Range 0-10).
Risk_Category	Classification (Low Risk < 4, High Risk >= 4).
Recommendation	Clinical guidance regarding prophylaxis and monitoring.

References

Maldonado JR, Sher Y, Ashouri JF, 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;48(4):375-390. doi:10.1016/j.alcohol.2014.01.004

Examples

# Example 1: High Risk (Score >= 4)
# Recent use, Hx of Seizures, Hx of DTs, Autonomic signs
pawss_score(1, 0, 1, 1, 1, 0, 0, 0, 0, 1)

# Example 2: Low Risk (Score < 4)
# Recent use, Hx of Rehab, Blackouts
pawss_score(1, 0, 0, 0, 0, 1, 1, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.