Table 3.

Associations Between Benzodiazepine Dosing Strategy for Alcohol Withdrawal Syndrome and Cumulative Benzodiazepine Exposure, Intensive Care, and Intubation, Unadjusted and Adjusted for Patient Characteristics in the Veterans Health Administration during 2013^a, ^b, ^c

Strategy	Cumulative benzodiazepine		ICU care		Intubation
	Unadj (95% CI)	Adj (95% CI)	Unadj (95% CI)	Adj (95% CI)	Unadj (95% CI)	Adj (95% CI)
	Coefficient		Odds ratio		Odds ratio
Fixed-dose	Reference	Reference	Reference	Reference	Reference	Reference
Symptom-triggered	30.5 (13.5-47.5)d	26.4 (9.4-43.4)d	1.7 (1.5-2.0)d	1.7 (1.4-2.0)d	1.6 (1.2-2.2)d	1.5 (1.1-2.1)d
Front-loading	175.9 (155.3-196.4)d	168.8 (148.2-189.4)d	3.0 (2.6-3.6)d	2.2 (1.8-2.6)d	5.6 (4.2-7.4)d	4.9 (3.5-6.9)d

	Predicted mean mg diazepam equivalents		Predicted probability		Predicted probability
Fixed-dose	179 (161-197)	182 (164-200)	19.9 (16.9-22.9)	21.3 (18.6-24.0)	3.2 (2.3-4.0)	3.5 (2.8-4.2)
Symptom-triggered	210 (192-227)	208 (190-226)	28.8 (25.2-32.4)	28.2 (25.0-31.3)	4.9 (3.8-6.0)	4.8 (4.0-5.6)
Front-loading	355 (333-377)	351 (329-372)	40.1 (35.7-44.6)	31.9 (28.2-35.6)	14.7 (12.0-17.3)	10.5 (8.9-12.1)

^eFor complete results of each model, including adjusted coefficients and odds ratios for each covariate, see Supplemental Table 6.

^aAdj, adjusted; ICU, intensive care unit; Unadj, unadjusted.

^bAll adjusted models included all patient demographic and clinical characteristics, all inpatient diagnoses, and hospital site as a random effect. In models of ICU care and intubation, cumulative benzodiazepine exposure was also included as a covariate representing alcohol withdrawal syndrome severity planned a priori—ie, greater severity of alcohol withdrawal syndrome will require greater amounts of counterbalancing medications.

^cHospital intraclass correlation coefficient for cumulative benzodiazepine, 0.05 (95% CI, 0.03-0.07); ICU care, 0.20 (95% CI, 0.15-0.26); intubation, 0.06 (95% CI, 0.03-0.13).

^dP<.01.