Thiamine Supplementation in Patients With Alcohol Use Disorder Presenting With Acute Critical Illness : A Nationwide Retrospective Observational Study.
Thiamine Supplementation in Patients With Alcohol Use Disorder Presenting With Acute Critical Illness : A Nationwide Retrospective Observational Study.
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DOI：
10.7326/m21-2103
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发表时间：
2022-03
影响因子：
39.2
通讯作者：
Donnino, Michael W.
中科院分区：
文献类型：
--
作者：
Pawar, Rahul D.;Balaji, Lakshman;Grossestreuer, Anne, V;Thompson, Garrett;Holmberg, Mathias J.;Issa, Mahmoud S.;Patel, Parth, V;Kronen, Ryan;Berg, Katherine M.;Moskowitz, Ari;Donnino, Michael W.
Thiamine supplementation is recommended for patients with alcohol use disorder (AUD). We hypothesize that critically-ill AUD patients commonly are not given thiamine supplementation. To describe thiamine supplementation incidence in AUD patients with different critical illnesses [alcohol withdrawal, septic shock, traumatic brain injury (TBI), and diabetic ketoacidosis (DKA)] in the USA. Retrospective observational study. Cerner HealthFacts database. Adult ICU patients diagnosed with AUD and admitted with alcohol withdrawal and/or septic shock, TBI, and/or DKA and admitted between 2010–2017. Incidence and predicted probability of thiamine supplementation in alcohol withdrawal and other critical illnesses. The study included 14,998 patients with AUD. Mean age was 52.2±12.6, 77% were male, and in-hospital mortality was 9%. Overall, 7,689 (51%) patients received thiamine supplementation. The incidence of thiamine supplementation for alcohol withdrawal, septic shock, TBI, and DKA, thiamine administration was 59%, 26%, 41% and 24%, respectively. The majority of those receiving thiamine (3957, 52%) received it within 12 hours of ED presentation. The predominant route of thiamine administration was enteral (3119, 41%). Specific dosing and duration were not completely captured. Thiamine supplementation was not provided to almost half of all AUD patients, raising a quality of care issue for this cohort. Supplementation was numerically less frequent in AUD patients with septic shock, DKA, and TBI as compared to those with alcohol withdrawal. These data will be important for the design of quality improvement studies in critically ill patients with AUD.
