Treatment variability and its relationships to outcomes among patients with Wernicke's encephalopathy : A multicenter retrospective study
Novo-Veleiro, Ignacio (Complexo Hospitalario Universitario de Santiago)
Mateos-Díaz, Ana-M. (Hospital Virgen del Puerto)
Rosón-Hernández, Beatriz (Hospital Universitari de Bellvitge)
Medina-García, José A. (Hospital Quirónsalud)
Muga, Roberto (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Fernández-Solá, Joaquim (Hospital Clínic i Provincial de Barcelona)
Martín-González, Candelaria (Hospital Universitario de Canarias (La Laguna))
Seco-Hernández, Elena (Complejo Hospitalario Universitario de Ourense)
Suárez-Cuervo, Carlos (Hospital Central de Asturias)
Monte Secades, Rafael (Hospital Universitario Lucus Augusti)
Machado-Prieto, Begoña (Complexo Hospitalario Universitario de Vigo)
Puerta-Louro, Rubén (Hospital Ribera Povisa)
Prada González, Cristina (Hospital de León)
Fernández Rial, Álvaro (Hospital Universitario Lucus Augusti)
Sabio Repiso, Patricia (Hospital Clínico San Carlos)
Vázquez-Vigo, Rocío (Complejo Hospitalario Universitario de A Coruña)
Antolí-Royo, Ana Cristina (Complejo Asistencial de Ávila)
Gomila-Grange, Aina (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Felipe-Pérez, Nieves C. (Hospital Quirónsalud)
Sanvisens, Arantza (Institut Català d'Oncologia)
Antúnez-Jorge, Emilia (Hospital Clínic i Provincial de Barcelona)
Fernández-Rodríguez, Camino-M. (Hospital Universitario de Canarias)
Alvela-Suárez, Lucia (HM Rosaleda Hospital, Santiago de Compostela)
Fidalgo-Navarro, Alba (Hospital Central de Asturias)
Castro, Joaquin (Hospital Vithas Xanit)
Polvorosa-Gómez, María-A. (Hospital Comarcal de Menorca)
Del Valle-Sánchez, Mario (Hospital General de Soria)
López-Castro, José (Hospital Público de Monforte)
Chamorro, Antonio-J. (Instituto Biosanitario de Salamanca)
Marcos, Miguel (Instituto Biosanitario de Salamanca)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2023
Abstract:	Background: Despite guidelines and recommendations, Wernicke's encephalopathy (WE) treatment lacks evidence, leading to clinical practice variability. Aims: Given the overall lack of information on thiamine use for WE treatment, we analyzed data from a large, well-characterized multicenter sample of patients with WE, examining thiamine dosages; factors associated with the use of different doses, frequencies, and routes; and the influence of differences in thiamine treatment on the outcome. Methods: This retrospective study was conducted with data from 443 patients from 21 centers obtained from a nationwide registry of the Spanish Society of Internal Medicine (from 2000 to 2012). Discharge codes and Caine criteria were applied for WE diagnosis, and treatment-related (thiamine dosage, frequency, and route of administration) demographic, clinical, and outcome variables were analyzed. Results: We found marked variability in WE treatment and a low rate of high-dose intravenous thiamine administration. Seventy-eight patients out of 373 (20. 9%) received > 300 mg/day of thiamine as initial dose. Patients fulfilling the Caine criteria or presenting with the classic WE triad more frequently received parenteral treatment. Delayed diagnosis (after 24 h hospitalization), the fulfillment of more than two Caine criteria at diagnosis, mental status alterations, and folic acid deficiency were associated significantly with the lack of complete recovery. Malnutrition, reduced consciousness, folic acid deficiency, and the lack of timely thiamine treatment were risk factors for mortality. Conclusions: Our results clearly show extreme variability in thiamine dosages and routes used in the management of WE. Measures should be implemented to ensure adherence to current guidelines and to correct potential nutritional deficits in patients with alcohol use disorders or other risk factors for WE.
Grants:	Ministerio de Economía y Competitividad RD16/ 0017/0023 Ministerio de Economía y Competitividad RD16/0017/0003 Ministerio de Economía y Competitividad RD16/0017/0018
Note:	Catedres
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Wernicke encephalopathy ; Treatment ; Alcohol use disorder ; Thiamine deficiency
Published in:	Drug and alcohol dependence, Vol. 252 (november 2023) , ISSN 1879-0046

DOI: 10.1016/j.drugalcdep.2023.110961

9 p, 593.8 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles