What is the maximum total CIWA-Ar score?

What is the maximum total CIWA-Ar score?

• A. 50
• B. 60
• C. 67
• D. 70

Answer: (C)

The key idea is understanding how the CIWA-Ar is scored across its items. There are ten items assessing different alcohol withdrawal symptoms. Nine of those items can each contribute up to 7 points. The tenth item, clouding of sensorium, is capped at 4 points. So the maximum total is 9 × 7 = 63 plus 4, which equals 67. This is why 67 is the highest possible CIWA-Ar score. Clinically, higher totals indicate more severe withdrawal and help guide treatment decisions such as benzodiazepine dosing. The other numbers aren’t achievable as the clouding of sensorium item cannot reach 7, making a total of 70 impossible; 60 and 50 would be possible totals, but they aren’t the maximum.

The key idea is understanding how the CIWA-Ar is scored across its items. There are ten items assessing different alcohol withdrawal symptoms. Nine of those items can each contribute up to 7 points. The tenth item, clouding of sensorium, is capped at 4 points. So the maximum total is 9 × 7 = 63 plus 4, which equals 67. This is why 67 is the highest possible CIWA-Ar score. Clinically, higher totals indicate more severe withdrawal and help guide treatment decisions such as benzodiazepine dosing. The other numbers aren’t achievable as the clouding of sensorium item cannot reach 7, making a total of 70 impossible; 60 and 50 would be possible totals, but they aren’t the maximum.